pro-disc L replacement surgery

pro-disc L replacement surgery

Posted in the Jonesboro Forum

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curious

United States

#1 Sep 8, 2008
My doctor wants me to have a lumbar disc replacement at L5-S1 using the new FDA approved Pro-disc L. However, I have Humana insurance and they have denied my first two appeals. I am going to try to appeal a third time but am not very optimistic Humana will change their decision. I am now scheduled to have a fusion in late October. I love to run (marathoner) and am scared I will not be able to be a long-distance runner or run at all if I have this type of surgery. Anyone with any comments or suggestions would be appreciated.

Since: Sep 08

J'boro

#2 Sep 8, 2008
Any clue what the surgery costs without insurance?
curious

United States

#3 Sep 9, 2008
Just the neurosurgeons charge for the procedure is around 13,000, this is not including the fee for hospital stay, anesthesia, and the fee of a second physician required present to move the vessels/intestines off of the spine (procedure goes through abdomen).

Since: Sep 08

J'boro

#4 Sep 9, 2008
Marathoners seem like a pretty good group of people, (albeit a little insane in my opinion...) maybe good enough to put a fund-raiser race together for someone who loves to run....just a thought. There are some pretty upstanding people in this community who are part of that crowd, and might know how to put something like that together. Ted Herget would be a good start, he's good people. The other choice would be to take a hard look at that much debt vs the quality of life you love...don't cost anything to run, and you've got the rest of your life to pay it back. They don't have debtors' prisons anymore. Whatever you choose, remember to pray. It can't hurt.
your neurosurgeon

Russellville, AR

#5 Sep 28, 2008
read your post. sorry to hear your insurance doesn't want to cover the new technology available for your problem. call me at the office to discuss options.
hope to run

Forrest City, AR

#6 Nov 4, 2008
I recently had a fusion at L5-S1 with hopefully good results. The sciatica pain I feel is almost entirely gone. However, when I cough or sneeze I feel that I am being stabbed in my lower back. I currently have a cold and am so fearful of the symptoms associated. Is this normal or a sign that something my not be right. I also have a new sympton/pain, which I feel that has probably been there this whole time but has been masked by the more severe herniated disc. I have a bulging disc at L4-L5 (hopefully still just a bulge). The symptoms I am feeling is a pain down the lateral side of my leg/ knee pain, and pain in my big toe. Any clues as to what may be going one would be appreciated. I am not due to see my surgeon until in December. To my "surgeon" if you are reading this, I do not want to call and talk to your office staff or nurse. I know how busy you are so if you get a chance to read and post, thanks in advance.
bonoite

Trumann, AR

#7 Nov 4, 2008
I have worked closely with NEA neurosurgeons and they will keep trying to get it approved. You could help out by having a lawyer contact your insurance. Insurance does not like communicating with lawyers so it may speed up the process. If you are under 60, dont get the fusion, you will probably never be the same. Hold out for the Pro disk it's worth it.
recovering

Ozark, MO

#8 Nov 6, 2008
I had the same type of surgery but at
C-5, the replacement disc has now been approved by the FDA so it should not be experimental. I have been told that all insurances approve surgery but not the prosthetic disc at first which is crazy, if my memory is correct around $8000.00 was not covered by my insurance after I payed my co-pays and deductables. Definitely wait for Pro disc. Good luck!
JENISBIZ

United States

#9 Dec 14, 2008
i AM WONDERING WHAT INSURANC COMPANIES YOU ARE EFERING TO. My husband has insurance through his work( Stillwater Mining Company) Unfortunatlly they are self insured in Montana. This means that they pretty much get to decide what they want to do without much jurisdiction. I am looking into supplamental ins. or going to Germany. Any suggestions or tips?
you never know

Sulphur Springs, TX

#10 Dec 15, 2008
Has everyone watched Michael Moore's "SICKO". It really made me sad and alittle scared after watching it. Hopefully some big "CHANGES" will be made soon. If you haven't seen it I suggest wathcing it.
doesnt make sense

Forrest City, AR

#11 Jan 19, 2009
I am still recovering from my fusion surgery at L5-S1. Feeling better, but can still not do the things I enjoy doing. I still can not run....which I have a passion for. My doctor says it will probably take 2 years to recover. I also need two more surgeries...cervial area and L4-L5. However, I am waiting out as long as I can. I have Humana insurance through my work. There is a "clause" in my plan since it is a group policy. It says that it will not cover anything considered to be experimental or investigational. It does not matter that it has been FDA approved now for approx. 2 years. There is still not enough post-data research out there on the long term outcomes of having these implants. Trying to switch to AETNA and Blue Cross/Blue Shield. However, I know that these companies are either going to deny me or exclude me for life for anything that has to do with my back. I pay over 950.00 per month for a family plan through Humana.

Since: Sep 08

Jonesboro, Ar

#12 Jan 19, 2009
Gotta love Chiropractors ;)
guest

Bossier City, LA

#13 Jan 20, 2009
I guess you could say that this is the beginning of a new era with spine surgery. it all started several years ago when one certain spine implant company released their Disc and it was a complete disaster. Failures left and right and a huge class action law suit against that company. the insurance companies where hit hard.
the new disc - pro disc by a company known as synthes www.synthes.com - has had a slow and steady rollout and has had great results. however, they are fighting a battle with insurance companies over reimbursement because of what happened several years ago. the insurance companies are coming around. its just going to take time and lots of good results. once the results give the long term data that science tells us they will, the insurance companies will accept the technology. They just want to make sure that they are reliable.
its a long battle. just hang in there and work with your doctor. the science is great and the technology that is in the implant is amazing.
and without saying his name, the NEA doctor who is putting these in is awesome! he is having some outstanding results. also, a big key to this surgery is that rather than the traditional back fusion they approach threw your stomach. the spine surgeon needs an 'approach surgeon" to handle the positioning of your vessels. the doctor that the nea surgeon uses may be one of the best in the nation - seriously!!!
couldnt ask for two better guys to be working on you!
doesnt make sense

Forrest City, AR

#14 Jan 21, 2009
I know the two doctors you are talking about and you are right...they are fabulous. They are the two surgeons that did my fusion surgery...they did go in through my abdomen. The assisting surgeon did a fabulous job on my incision. I am going to hold in there b/c these are the only two surgeons that I want cutting on me. I agree with you... I think he is one of the best in the nation as well. Hopefully, having him as my neurosurgeon will help in getting my insur. to approve. Just hope I don't have to wait too long. I am only 36. I am a mother of 3 small children and have to work full time. My quality of life has significantly been affected. It is very hard to stay positive when you just don't know how much longer you are going to have to wait to feel somewhat "normal" again. Thanks so much for your input.
Shane

Christmas, FL

#15 Feb 12, 2009
I had an L5-S1 Pro-Disc Replacement and was told that the pain relief should be complete within 12 weeks.For nearly a year I was having lower left back pain and was told that I had DDD and a bulging and herniated L5_S1 disk. I am very sad to say that 12 weeks has past and I am still in quite a bite of pain. My biggest concern is that the pain Is very similar to the pain that I had before my surgery. This has me praying that I was not miss-diagnosed as anyone that has had back surgery knows that it is a tough life experience to go through. Now 12 weeks after the surgery my doctor is starting me on a series of epidurals which also has me nervous . If there is anyone else that had this surgery I would like to here your outcome. If you are thinking about having this surgery I advise you have all test available done to insure that this is the only option .
Secret Squirrel

Big Spring, TX

#16 Feb 12, 2009
I too am waiting for the Pro Discs. I need three in my c spine. I have BCBS and they refuse to cover it. So, I wait. Anyway.........I have had several of the cervical epidurals and I suppose different folks get different results. It took about 48 hours for the epidurals to kick in and work on me..........and then they lasted approximately one week. They are quite costly also, especially not to get longer relief than that. They may help others better though. They are just pain and inflammation relief though, so won't last forever on anyone.
I am anti-drug, but after suffering through this ordeal, I can truly see now how some people get addicted to pain medication. I probably would too, but I have a two year old and a teenager anddon't want to be a zombie and miss out on them. Does anyone else that is waiting for surgery have a problem concentrating on anything else because the pain takes almost your entire mind? Sometimes I get to the point where I don't think that I can take it anymoe.
amanda

Lake Charles, LA

#17 Feb 12, 2009
I have been recently told that I have a herniated L5-S1 disc which is pushing out in the center and to the left. Many lower back and left leg muscle spasms along with tingling and numbness in left foot. All I have been given so far is pain meds and anti-inflammatory meds. My DR is in LR and he said something about a nerve block being done soon. What relief will that bring and how long will that last? When will I be able to return to work?(lots of heavy lifting, bending, twisting, stooping, squating, uneven walking surfaces, standing and sitting for long periods of time) How long will I be in pain in general?

This is my first time have this sort of injury. This happened 3 wks ago.
doesnt make sense

Wynne, AR

#18 Feb 17, 2009
Amanda, are you from Jonesboro? If so, why are you going to LR. when DR. Kenneth Tonymon at the NEA Clinic is one of the best in the country. Just curious... he is highly recognized. Did a fusion a L5-S1 on me in Oct. and I am doing much better. He is a fabulous doctor. The nerve blocks did not help me at all. How are you going to continue in your line of work with the activities you have to perform? Best of luck to you. I understand the pain and frustration....I've been there. I still need 2 more surgeries as well.
Amanda

Lake Charles, LA

#19 Feb 18, 2009
doesnt make sense wrote:
Amanda, are you from Jonesboro? If so, why are you going to LR. when DR. Kenneth Tonymon at the NEA Clinic is one of the best in the country. Just curious... he is highly recognized. Did a fusion a L5-S1 on me in Oct. and I am doing much better. He is a fabulous doctor. The nerve blocks did not help me at all. How are you going to continue in your line of work with the activities you have to perform? Best of luck to you. I understand the pain and frustration....I've been there. I still need 2 more surgeries as well.
Workman's comp is sending me to Little Rock for this DR over there. Today is the 4 wk mark of injuring my back. My PCP didn't do a MRI, instead he did a CT of my back. So when I went to LR, the first thing that DR did was order a MRI for me. That is all that has been done so far. I'm just really really frustrated at the fact that I have been on pain meds and laying down/taking it easy for 4 wks. I am not a person who sits around and does nothing. This has totally brought my world to a sudden stop. I just want to know what is going on with my back and what they are going to do about it. I want my life back to what it used to be. Hell, I would love to even be able to vacuum, change the sheets on my bed, dust the house etc. Now I am having to rely on others to help me out with it.....which is very embarrassing for me to have to ask others for help. aarrggghhhh........sorry, had to vent there for a little bit. I just want off this damn couch. I have learned that it isn't as comfy as I once thought it was. LOL
Amanda

Lake Charles, LA

#20 Feb 18, 2009
OH ya...Doesn't Make Sense.....DR said that I have a 95% chance of returning back to work in full swing. I am so happy and relieved to hear that but I want to go to work now. He said that I was too young to have back problems like this and that he didn't want to do surgery b/c if I had one, then I would have to have another one in a few yrs, then another one; would be pretty much on a cycle of surgeries every few yrs. He is wanting to do a nerve block on me.....I am hoping that will work. I don't know when he is gonna do it tho...I just hope soon!

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