Second opinion

A fusion recommendation is a reason to look twice — not a verdict.

Patients and referring physicians can ask whether the problem still allows motion to be kept. Sometimes fusion is the honest answer. The visit is to find out which.

Quiet corridor in an academic spine clinic

Many people arrive after another surgeon has already recommended fusion. That is a common, legitimate plan — and it is also the moment when a second look at the MRI and the exam can change the operation, or confirm it.

Dr. Li’s rule is simple. If cervical disc replacement, laminoplasty, or a muscle-sparing decompression such as ULBD can treat the compression, fusion is not the first recommendation. If the joints are destroyed, the segment is unstable, or alignment must be changed, fusion is the reconstruction — not a failure of philosophy.

“The operation should match the mechanical problem. A second opinion is how we check that match before you live with it.”

New patients are welcome, including out-of-state and international second opinions. Appointments are available in English and Mandarin Chinese at UVA Spine Care on Ivy Road.

Read how those choices are made: disc replacement vs ACDF, laminoplasty vs posterior fusion, ULBD vs fusion, and when fusion is honest.

For patients

What to bring

Recent MRI of the relevant spine (disc, preferably within a year), on CD or already in the UVA system
Standing x-rays if posture, scoliosis, or flatback is part of the story
The clinic note and operative report from the surgeon who recommended surgery
A list of medications, prior spine operations, and your questions written down

How imaging gets here

Already at UVA (MyChart or a prior visit) — tell the clinic; nothing else to send
Hospital image share to UVA Health — the usual path for an outside MRI
CD or USB brought to the Ivy Road visit
Referring physician fax of reports to 434-243-1539 — images themselves still need a share or a disc

If imaging lives at another hospital, ask them for a disc or a share to UVA before the visit. The exam is more useful when the films are in the room. This website does not store MRIs or x-rays.

For physicians

How to refer

Call the spine clinic at 434.243.3633. Fax records to 434.243.1539. A useful packet is the most recent clinic note, MRI and x-ray reports (and the images themselves), and any operative report if the patient has already had spine surgery.

Questions that travel well: a fusion has been recommended and motion preservation is being considered; multilevel cervical myelopathy; lumbar stenosis in a still-stable spine; adult deformity that may need reconstruction rather than a short decompression.

Patients remain under your care unless they choose otherwise. A second opinion can return a letter, not a takeover.

Request a second look

This note is a request, not a scheduled visit. The office confirms appointments. Calling is faster.

Educational information, not medical advice. A second opinion does not create a treatment relationship until the clinic visit is completed.

FAQ

Questions about a second opinion

I was already told I need a fusion. Is a second opinion still useful?

Yes. A second look can confirm that fusion is the honest reconstruction — or it can identify a motion-preserving option such as disc replacement, laminoplasty, or ULBD that still treats the compression. Either answer is useful before you have surgery.

Will Dr. Li automatically disagree with my other surgeon?

No. Fusion is part of his practice when the segment cannot safely move, when alignment must change, or when the bone itself is the disease. The visit is to match the operation to the mechanical problem, not to reverse someone else’s plan on principle.

Do I need a referral?

Insurance plans differ. Many patients are referred by another physician; some schedule directly. Call 434-243-3633 and the clinic can tell you what your plan requires.

How do I send my MRI?

This website does not store medical images. If studies are already at UVA, we can use them. Otherwise ask the other hospital to share to UVA Health, bring a CD or USB to the visit, or have your referring physician fax reports to 434-243-1539.

Appointments

Ready to take the next step toward recovery?

New patients are welcome. Call the spine clinic or send a note — the team will help you find the right visit.

Request an appointment Call 434.243.3633