Doctor needed!!

[rhatzy]

Stenum is 27000 euros which is about $33,000. It'll cost you twice that here in the US. BCBS is now paying for a one level cervical.

Mark

[Carson]

Overall is it looking like BCBS is our current best provider, Mark?

It seems Blue Cross is, relatively, the most ADR friendly insurance company to date.

[Carson]

As others said, Frank, there are certianly US surgeons providing multi-level procedures; I know Dr. Zigler, Dr. Regan and Dr. Delamarter have all performed multiple levels for example but the insurance matter remains a challenge.

To my knowledge: as long as the disc itself is FDA approved the surgeon can decide to use one or more; though insurance co's, thus far, are only covering one level procedures.

[runagain]

The Blues along with United Health Care are among the worse companies to cover ADR. However, there are a few blues like Montana BC that cover lumbar or cervical in their policy.
One level.
The insurance companies would like to let you think they do not cover any ADR but they do. Aetna is among the best. Kaiser covers as a matter of policy also.
I agree Laurie has valuable info.
If you want further info, you can PM me.
Put it this way, I have friends who got multi level ADR in the United States.
and there are surgeons putting in multi level ADR, both cervical and lumbar, in the good ole USA.

R

[KBear]

Hi

I very much need to know of doctors in my area and/or the US with experience doing multi-level cervical ADR. I've been waiting over a year to see if my insurance co (United Healthcare) would begin covering the surgery or to figure out a way to pay for surgery at Stenum or Prospine or to get into a clinical trial somewhere.

Now I have no choice as I have deteriorated dramatically in the past two months. Cord stenosis affecting all limbs. Nerve root compression now resulting in weakness and loss of fine motor control. etc.

Are there any surgeons performing multilevel cervical ADR in South Florida?
How about anywhere in the US?
Frank

Check Dr. Garcia in Aventura, Florida. He did my surgery through a trial, but he is also the inventor of the Active L disc. I am really pleased with my surgery and would highly recommend him. I'm not sure on the multi-level, but I would bet he has done them.

[Cindylou]

I sure would like clarification on this myself. It has been my understanding (and I may be way off, so that's why I would like a definitive answer from someone who really KNOWS) that here in the USA, we are bound by the FDA rules and guidelines (forget about insurance for awhile....that's a whole other topic!) and that only 1 level of adr has been approved for both lumbar and cervical. And that the only other way in the USA to receive a multi-level disc is through a trial. USA doctors are not allowed to willy-nilly install multiple discs outside of trials, or what is the point of the FDA ruling?! What really irks all us Americans is having the FDA make a ruling and then not to have our insurance carriers support it and approve it! It should be against the law!!! Justin, do you know the "final answer" to all the rumors about multi-level disc surgery in the USA outside of trials?

[JK2234]

^Cant be true b/c I know people in Delaware who got 2 level pro-disc.

also medicaid will do a 1 level pro-disc

[runagain]

The FDA approved one-level disc but has not approved two level. However, doctors can do the surgery as "off label". Physicians often do surgeries, prescribe medications as an "off label" application.
For instance, BMP (bone morphogenic protein) was approved by the FDA under certain conditions. But physicians used BMP as "off label" in a lot of fusion cases.
One stipulation by the FDA was not to use BMP in cervical fusions, but some surgeons did. A few people died or needed emergency tracheostomy because the BMP caused swelling in their necks, which led to them not being able to breathe.

It is perfectly legal to use things "off label" and its use is widespread among doctors. Another example is when doctors discovered the drug Minoxidil, which was initially used to treat high blood pressure because it is a vasodilator, also helped with men's hair loss. This discovery and use of Minoxidil eventually led to the drug used for hair growth.

I have known people who received multiple ADRs, usually doubles, through workers compensation and medicare. Even most of our well-known insurances have paid for multiple ADR surgeries.
And if you have the money, you can pay for surgeries out of pocket. Now, not every doctor does multiple ADRs but there are several in the US that do.

As the use of ADRs grows more widespread in the US and the skill level of the surgeons goes up, more multiple ADR surgeries will happen.
Heck, I was surprised to meet a police officer in a taco shop a couple of months back that had an ADR and was going to have surgery to put in another ADR and a fusion.
It is getting more common place when you meet other ADR patients, unexpectantly. LOL.

R

[Cindylou]

Runagain, thank-you so much for such a thorough explanation. Much appreciated. Personally, I wouldn't let a surgeon who has done 3, 5, hell even 100 adr's, come near me with a 10 foot pole. Hence, the run to Europe. Things are slowly changing. Thx again.

[runagain]

No problem CL.

Not every doctor is going to do a mulitlevel, especially if they do not have the experience.
But some insurance companies are covering it, but they won't advertise it.
I would like to see the day when a lot of people do not have to go to Germany or other countries.
The last e-mail/post from Laurie (the insurance warrior) made a point about the success rate of fusion, that it is not that high and varies among surgeons, like anything.
I have read something like 45 percent on average and then I was reading some old stuff (prior to my surgery) where one doctor offered a success rate at something like 56 percent.
That is not very good. I am glad I did not go with him.
We have to be careful of what surgeon we get, his or her's expertise, their experience, success rate, what quantifies success, etc...
Some surgeons are so good, especially ones that have extensive fusion experience, that they can "learn" another surgery without too much difficulty. But I have read that a surgeon needs to do about one hundred surgeries before they do their best, perfect their technique, etc...
Keep on healing, Cindylou,

R