@migizii Am I understanding you correctly, that you saw an orthopedic spine surgeon at Mayo for a collapsed L3/L4 disc and they said no to surgery, but another surgeon since then recommends surgery if conservative treatment fails? It sounds like you have not improved with physical therapy, etc. Have you seen a spine neurosurgeon? Both otho and neuro can be spine surgeons. Do you have other health issues that would make you a poor surgical candidate? One problem of being on "Medicare", if you are not on genuine Medicare, and are on a "Medicare Advantage" plan is that Mayo might not accept that. A patient I know just ran into that. Not all Mayo campuses take original Medicare (if I'm not mistaken). I think Rochester does take original Medicare. I called them and asked that question and I chose a Mutual of Omaha Medigap policy to go with it so I could be sure I would be covered if I needed further treatment at Mayo. It's time to sign up for next year's insurance, and perhaps you can change it so it is acceptable at Mayo.... worth a phone call anyway. I think you probably could get other opinions at Mayo if the insurance coverage was not an issue. Also in MN, you can see Mayo trained surgeons at the Mayo Clinic Health System in some other towns.

Here is a large question list I compiled about spine surgery, and not all may be pertinent to your case.

~ QUESTIONS ABOUT SPINE SURGERY ~

What type of surgery are you recommending? Why? What is the specific anatomic lesion being addressed?

What is the natural course of my condition if it is not surgically addressed?

Why does the surgeon recommend this specific procedure? What are the potential results for this surgery? Why am I a good candidate for this surgery?

What is the source of the pain that is being addressed? How do you know this?

Please explain the procedure in great detail.

What products and implants are used? Is everything to be used FDA approved for this application?

What are the chances that the osteophytes will regrow? If so, what will minimize that chance?

What are my non-surgical options?

What are the different surgical procedures that can address my problem?

Can the disc be saved?

What would you recommend if I was your friend, wife, sister, or daughter?

How long will the surgery take?

What are the side effects, potential risks, and potential complications?

Please explain the risks and how they relate to me personally.

Reactions to implants, metal sensitivities, plastic sensitivities, toxicities?

What happens to artificial disk as it wears? How long would it last? Any not made of metals?
Are the metals used the same or different within the implant?

How great is risk of adjacent segment disk degeneration with a fusion? Are there other discs that show degeneration now that could become problematic in the future? Do you think I will have a problem in the future on adjacent levels?

Do I have to have a metal plate on my spine? Is there another way to stabilize the spine?

What if, during my surgery, you encounter a different spine issue than you expected?

What is the risk/benefit ratio (the chance of a bad outcome as weighed against the chance of a good outcome)?

Do any of the materials used increase my chances of getting cancer?

What are the standard safety procedures to insure my safety during the surgery?

What are the safety cross check procedures during surgery?

What kind of imaging is used during the procedure and how does it tell you what you need to know?

Are there electrodes on extremities (neuro monitoring) making sure the nerves are functioning?

Do I need to donate my own blood? If yes, why?

Do you perform the whole procedure? Will any students and/or other surgeons be doing any parts of the operation? If yes, What are their background and qualifications?

Can I talk to other patients who have had a similar procedure?

Who else will assist you in the operation? What are their background and qualifications?

What are the long-term consequences of the proposed procedure?

~ QUESTIONS ABOUT THE SURGEON ~

How many times have you done this procedure?

Are you fellowship trained in spine surgery?
This is more important if the surgery is a fusion, artificial disc replacement, or other more extensive procedure.

If I want to get a second opinion, who would you recommend?

Statistically, what is the success rate for this type of surgery? What is your personal success rate, and how many of this type of surgery have you done?

~ QUESTIONS ABOUT WHAT TO EXPECT AFTER SURGERY ~

What kind of pain should I expect after the surgery and for how long?

How long is the hospital stay?

May a family member spend the night with me in the hospital?

How do you manage the pain in the hospital?

Which pain medications will I be sent home with? What are possible side effects of these prescriptions (e.g. constipation, drowsiness, etc.)?

Who can I call if I have questions after the surgery? What is the process for communication?

How often will I see you after my surgery?

What symptoms would warrant a call to your office?

What symptoms would warrant immediate medical attention?

What limitations will I have after surgery and for how long?

How long should I wait to bathe?

How long will I be out of work? School?

What kind of help will I need when I return home?

When can I drive again?

When can I resume normal (light) household chores?

What expectations do you have for my recovery?

How soon after the surgery can I start physical therapy?

So that was a lot of questions.
Here are some other discussions to check out:

Podcast about Spinal Stenosis
https://connect.mayoclinic.org/blog/podcasts/newsfeed-post/spinal-stenosis-1/
Spine Lumbar Fusion Surgery
https://connect.mayoclinic.org/discussion/spine-lumbar-fusion-surgery/
Are you considering getting some other surgical opinions?

Hello, I am also on this journey to seek different MDs to get answers to my severe spinal stenosis. I saw a neurosurgeon, and he suggested a Pain Management doctor, who set a treatment plan that included a spinal injection of cortisone and lidocaine, along with a regimen of oral pain medications. PT was also set up, but did not help much. And, yes, all of this IS covered by Medicare plus your supplemental insurance. Thus far, this regimen has helped with the daily management of my pain; however, it seems to be only about 30% effective. I saw my neurosurgeon again, and he is now suggesting surgery. I am actively seeking other medical opinions; only one neurosurgeon has responded, and I am still waiting for the second neurosurgeon to set an appt (FYI, the surgeons that are in most demand will NOT just allow the patient to schedule an appt; rather, the MD will screen the patient to determine if the patient fulfills their requirements to even be seen). So my journey continues.