Hello Spine Patient Society

[AJUinSD]

Hello All,

I’m a 56 year old and a very active guy living in San Diego, CA. I’ve been fighting back and neck issues for over 25 years. The result of years of playing sports, motorcycles and mountain bikes. Two very bad motorcycle accidents (not my fault) were the proverbial straw that broke the camel’s back. I ended up having a lumbar laminectomy at L5-S1done in 1989. After the surgery, I continued to run, play basketball and beach volleyball as well as mountain bike (I gave up motorcycles). I actually played in a beach volleyball league playing against my back surgeon for several years. I continued to be very active until about 8 years ago. My active life style and all the damage done had taken its toll. I had to stop everything. I had trouble getting up and down from my desk, couldn’t run or ride my bike and had trouble driving any distance or flying. If I did take a long drive or fly any distance I could barely walk.

By this time I was in San Diego and I knew I had to find a solution for my back issues. First step was to find a new doctor. I was fortunate as my wife works as a rehab therapist at a major rehab center here in SD. She sees hundreds of patients and she knew which doctor got the best results. After consulting with my new doctor and having MRIs, a discography and a half a dozen other tests, it was determined I had only a few millimeters of disk left at the L5-S1 and L4-L5 levels. At this time the only FDA approved solution was fusion. From the research I’d done, I knew fusion wasn’t the best solution and was a bit of dice roll. I also discovered artificial disc replacement (ADR) and that FDA approval was imminent. One of the reasons I chose my new doctor was that he had conducted pilot studies of ADR and had done hundreds of them. So I waited and managed the pain as best I could. About a year and half later the FDA finally approved the procedure and I was able to get approval and a compassionate dispensation from my insurance carrier (Aetna) to do a multilevel disc replacement. That was almost 5 years ago and I couldn’t be happier with the result. The recovery was difficult but after about a year my lower back felt great and I have been able to resume a lot of the activities I used to do. Not at the same level or frequency but I can do more than I ever thought I’d be able to.

Unfortunately that is not the end of my story. Also as a result of my injuries and the wear and tare of my life style, over the last 2 years I have developed significant issues at the C4-C5 and C5-C6 levels of my neck. In the interim since my last surgery, my insurance carrier has changed. It is now Anthem. And even though ADR for the cervical spine is FDA approved, they have taken the stance that disc replacement is experimental and investigative. Fusion is an option but the research I’ve done shows that ADR is a better solution. Research I’ve done, I’ve read dozens of studies and insurance carrier position statements, has shown that the recovery time is shorter, mobility is better and potentially has better long-term results. After doing the research, consulting with my doctor and considering the results I’ve had with my back, I believe ADR to be the best solution.

So I’ve decided to fight for what my doctor and I believe is the best solution. This is what led me to the Spine Patient Society where I hope to find resources and support that will help me in my struggle. In the interim, I’ve been managing the arm and neck/back pain with the help of the Scripps Integrative Medicine clinic using both holistic and traditional medicine. This includes non-steroid trigger point injections, dietary supplements, bio-feedback, meditation and more. I realize that it is only a band-aid solution but it has really helped and in my humble opinion is better than pain pills and epidural steroids.

Any suggestions, help or support will be much appreciated.

[trkdoc714]

AJU,

I'm in the same position. Aetna covered lumbar ADR in 2009 but the carrier is now BCBS with the same answer for the C6/7 issue, no ADR coverage. I have to run now but hopefully we can find a solution to win approval from BCBS.

Bob

[AJUinSD]

Hey Bob,

Thanks for replying, it is nice to know I'm not alone. I've got some new info and will post it if it brings any results.

Regards,

AJU

[Justin]

Hey AJU,

I just wanted to welcome you to the Spine Patient Society before I was headed out the door. It's great that you are managing your symptoms with varied, integrative approach. It's refreshing to see that Spine Patients are utilizing many "tools" available to them before ultimately pursuing an invasive surgical option.

Have you been appealed to your insurance company as of yet? Let me (us) know if you have any questions in particular and be sure to visit the other Sub-Forums (Health Insurance, Domestic and International Travel, Surgical Outcomes, etc.).

Good luck!