Discogram and Surgery Consult results

[iluvthebeach]

I saw the doctor for the discogram results and the ortho surgeron to discuss my options and neither one of them had encouraging news. Dr. Maurer said my l4-l5 disc has a pain level of 7 out of 10 and only handled 28 psi of pressure and my l5-s1 has a pain level of 8 out of 10 and could only handle 25 psi of pressure. He said a normal disc should be able to handle 100 psi of pressure.


Dr. Balderston said my vertabrae above my l5-si disc has slipped back and was rubbing on the vertabrae below my l5-s1 disc. My options - 2 level fusion (which my insurance company will pay for) 1 level fusion and 1 level disc replacement (my insurance will pay for each separately but not together) or live with the pain. Gotta check out my options and do some more research. He said that since my insurance company would not pay for the hybrid surgery he would totally recommend the 2 level fusion and didn't think it would adversely affect me. But Dr. Maurer had said that given my condition, he could see the discs going up my back going bad as well. Wouldn't a 2 level fusion start that process sooner rather than later?

It wasn't a good day for me and now I am at a loss as to what I want to do.

[bigdogchief76]

My options - 2 level fusion (which my insurance company will pay for) 1 level fusion and 1 level disc replacement (my insurance will pay for each separately but not together) or live with the pain.

First off, chin up! Easier said then done; but keep your head up. It will help to keep a positive mind-set with the road you have ahead.

This forum is here to help you through this. Don't be afraid to pm if you just need an ear to unload on for venting.

2 LVL fusion is pretty significant. But, at the area its needed, it might be the best option. I'm not a doctor (just play one on TV), but I can't believe a neuro/orthopedic would fuse you at L5-S1, wait a year and then put an ADR at L4-L5. Perhaps Justin can increase our brain knowledge on this. Better to do the hybrid all at once. (like your insurance dictates for covering the procedure)

Just a thought - but perhaps making a table in MS Word and tabulating all the pros and cons for the 2 LVL fusion might help? It would at least help with the research of this procedure.

Hang in there...

MB

[iluvthebeach]

2 LVL fusion is pretty significant. But, at the area its needed, it might be the best option. I'm not a doctor (just play one on TV), but I can't believe a neuro/orthopedic would fuse you at L5-S1, wait a year and then put an ADR at L4-L5. Perhaps Justin can increase our brain knowledge on this. Better to do the hybrid all at once. (like your insurance dictates for covering the procedure)


MB

Thanks MB. Dr. Balderston said he would not do 2 separate surgeries. He said he wouldn't risk it and I don't know that I would want to go through 2 separate surgeries. He said that he has dealt with my insurance company before and has not won an appeal for a hybrid surgery. He also said that Aetna would rather I pay out $75k for the surgery and then deny me. Yeah, like that would ever happen!

I work for an attoreny's office so I am going to see if anyone wants to take on an insurance company and set a precedence.

[Justin]

Dr. Balderston is a great surgeon (I see him for my follow-up). His patients love him and his surgical skills are truly second to none. It's unfortunate that your insurance company is denying your surgery.

Two separate surgeries is definitely not the way to go (only my opinion of course). Spinal fusion has really advanced over the years and for some Spine Patients it is the best surgical option available to them. Artificial disc replacement surgery has great promise; however, it behooves Spine Patients to make sure they do not have advanced facet degeneration, which is a contraindication to ADR surgery.

I don't have the link now, but there is a thread in the Artificial Disc Replacement Forum that spells out the indications and contraindications for ADR surgery. Make sure to do your research and thoroughly work up your facets to make sure you are a good candidate. Also, remember that spinal fusion is a great alternative and is the best choice for many Spine Patients.

Goodluck and keep us posted!