Why is replacement disc surgery so hard to get approved by Insurance company,I've appealed 3 times?
I've been sent to an orthorpedic surgeon,by my pain management Dr.and have had every test for problems with my lower back,this has been going on for 2 yrs,The diagnoises found many problems and the surgeon finally told me that the last test a discogram, after 5 MRI's and a myelogram.The best decision was a 3 level replacement disc procedure,because my discs on the bottom are crumbling from arthritis,so this was the way to go,also they had found a scheloma(tumor)on my spinal column.If the Insurance co doesn't allow this procedure to be done,all they're allowing is fusion,is that going to help my problems at all?
The medical research results do not stongly support the use of disc arthroplasty (replacement) over fusion. This especially holds true for three levels. The best results with disc arthroplasty are in young individuals with one level disc herniations. Serious complications, like implant settling, have been encountered especially in older individuals with weaker bones.
Insurance companies know the medical research and base their decisions on the medical evidence. Ultimately, treatments decisions by doctors and insurance companies need to be evidence-based decisions. Fusion may be your best surgical option, but that needs to be determined by your doctor.
Dr. Christina Lasich, MD
-
- Ranked Helpful (1)
- Report Abuse
Safe Medication Use
Learn the safest practices for medication use and what to ask your doctor.
