Lumbar Spine Issues, Looking at Stenum for Artificial Disc Replacement

[sd59]

Howdy

I tried to get to this page earlier, but think a popup blocker prevented it.

My name is Doug, I live in San Diego, and have had back pain for over 10 years.
Had neck pain, or rather radiating pain to my elbow, and opted for fusion many years ago before anything was available.
Pain went away, but restrictions on head movement is there.

In 08, I had an MRI showing L3-4, L4-5 and S1 as not so good.
Pics for L3-4 has black space where disc appears to be missing for about 1/3 of total disc.

Have been able to put up with the pain, until several weeks ago, when a nerve sent a message to my right hip, which increased to the point where I could hardly crawl without getting nauseous.

Pain lasted 2 days, with little respite, and has not come back since, but has me nervous.

I hope to have replacements put in, and have been looking at Stenum, and plan to meet with some of their Dr's in Phoenix this month.

Also looking for people who have had their insurance cover a portion of the surgery, as a rep from Blue Shield said they would not if I went out of the States.

Found a site where people ask questions, and several discussed insurance topics, but could not find it when laptop shut off accidentally.

That's about it.

[New-disc]

I had surgery @ Stenum... workers comp. ins. did not pay for my treatment out of the USA.

Some members on this site have re-cooped payment.

Todd

[sd59]

Todd

Sounds like your replacement went well.
I have viewed several U Tube videos Stenum put up, that show a woman from start to finish, and they explain quite a lot.

I was talking with the U.S. rep for Stenum, (Sue) from Michigan, who had 3 replacements.
She had the earlier ceramic discs, but not the latest M6, and I told her the guy you are standing with looks a little like Jack Nicholson, when he had hair.
She did not seem amused.

I used to live in Mass, and enjoyed visiting the states around it.
What amusement park were you at in the picture?

Doug

[scduggan]

Dear Doug,
Welcome to the website! You will get lots of help from the folks here. When you feel like it snoop around to find info about the insurance situation. It seems like I have seen people reimbursed for surgery performed overseas. I also have serious lumbar issues so my heart goes out to you. Good luck with your research. There are tons of members in this forum with a lot of good advice and experience.
CD

[sd59]

Thanks CD for the warm welcome.
Curious as to what is the denial from UHC?
Is it your insurance?
What type of replacements are you going to get?

Doug

[Justin]

Hi Doug,

Welcome to the Spine Patient Society!

I hope we can help support you and answer some of your questions. In terms of Stenum Hospital reimbursements, see these links for some information that might help:

• Happy Days!!!! Anthem BC/BS, Artificial Disc Replacement (In-Network Reimbursement, Stenum)
• Anthem-BCBS // Two-level Lumbar Artificial Disc Replacement Approval // Stenum (Germany) // June 2009 // 100% Patient Reimbursement

I do hope you find a "solution" to your lumbar spine problems and if I can be of help, please don't hesitate to contact me. BTW: I believe CD is going to be in the Axiomed Freedom Lumbar Disc trial.

Once again welcome and we are here to support you!

[scduggan]

Doug,
Hey There! I can be a little guilty of rambling, so I will try to be brief. I found out in late summer 2009 that I need a new disc at L4/L5. I suffer from degenerative disc disease at this level. I have been trying various conservative treatments for the last 2 1/2 years with no lasting results. I consulted a Neurosurgeon and a Orthopedic surgeon. Both docs are in agreement about my need and candidacy for ADR. My options were ADR, fusion or a life of narcotics. I think fusions have come a long way and are much better than they used to be. I think I would have considered it had my degenerated disc been L5/S1. UHC is UnitedHealtcare-my insurance company. Both surgeons tried to get ADR covered for me. I also spent a gazillion hours on a really good appeal letter to United. Boy have a learned a LOT in these last months. The bottom line is United does NOT cover ADR according to their medical policy---Period! I have never had any health problems. The only surgery I have ever had is my three c-sections for my three sons. I did not know about an insurance company's ability to say a big fat NO to something recommended (and backed up by all the proper diagnostic tests) by a policyholder's physician(s). I was denied three times by United. I spent a few weeks going through a whole slew of emotions....mostly bafflement and anger. ADR is FDA approved!!!!!! Something happened (no doubt an answer to my prayers) and I realized I had to let this anger go. It was toxic AND zapping what little energy I have. Spine Patient Society has been a lifesaver to me because of all that I have learned in a short amount of time. I do not want the info from the disc manufacturers and doctors.....I want info from PATIENTS!---people who have been in my shoes and come out on the other side. It was on this website that I learned about clinical trials. There are several ongoing trials for DDD. The one that seemed best for me is the Axiomed Freedom Lumbar Trial. This is a multi-center, blind study between ProDisc and the new Freedom lumbar disc. I contacted Texas Back Institute and after jumping through a few hoops (gladly) I am awaiting my ADR surgery February 18th with Dr. Zigler. I now know this is where I am supposed to be. I even think it is a blessing about the whole insurance thing. Dr. Zigler and Texas Back are outstanding. I will travel back and forth from Nashville to Texas. I feel at peace about this and SO READY to get this show on the road.

Sorry, Doug for all the details. I just wanted to convey to you how important it is to look at ALL YOUR options and do tons of research. Spine surgery is scary. Do you think you will need three levels? The trials are only for one level, but I am proud of you for checking into going to Germany. They have great outcomes. The more opinions you can get the better. All the successful outcomes have been from a case where patient selection is of the utmost importance. Equally important is surgeon skill, and I think that is a no-brainer if you plan on going to Germany. You will learn a lot along the way and will most likely have a gut feeling about what is best. Do not get discouraged. Keep us posted and check in often.
CD

[Lydia Watson O'Brien]

I had a two level lumbar replacement at Stem and I would highly recommend going there. I have the Mavrick and it has worked out great for me. Only a few insuraces are covering the replacement but I can tell you that if you have BCBS don't bother. We took a second mortgage out to cover my replacment. Good Luck

Lydia

Howdy

I tried to get to this page earlier, but think a popup blocker prevented it.

My name is Doug, I live in San Diego, and have had back pain for over 10 years.
Had neck pain, or rather radiating pain to my elbow, and opted for fusion many years ago before anything was available.
Pain went away, but restrictions on head movement is there.

In 08, I had an MRI showing L3-4, L4-5 and S1 as not so good.
Pics for L3-4 has black space where disc appears to be missing for about 1/3 of total disc.

Have been able to put up with the pain, until several weeks ago, when a nerve sent a message to my right hip, which increased to the point where I could hardly crawl without getting nauseous.

Pain lasted 2 days, with little respite, and has not come back since, but has me nervous.

I hope to have replacements put in, and have been looking at Stenum, and plan to meet with some of their Dr's in Phoenix this month.

Also looking for people who have had their insurance cover a portion of the surgery, as a rep from Blue Shield said they would not if I went out of the States.

Found a site where people ask questions, and several discussed insurance topics, but could not find it when laptop shut off accidentally.

That's about it.