Are there any studies to prove that surgery done to release the greater occipital nerve with partial resection of semispinalis muscles is not investigational? Insurance is claiming not enough of these surgeries have been done. Do you have numbers to prove otherwise?
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Q: What studies show occipital nerve surgery is not investigational?
Answers (2)
8/ 8/09 3:44pm
DKOhio,
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Is the surgery you're asking about the one discussed in this article? Plastic Surgery for Migraine? The occipital area is one of the locations in that study. If so, that's the only"official" clinical trial I know of for that procedure, and I know of no insurance companies that pay for any surgical procedure for the treatment or prevention of Migraine.
Welcome again, and good luck,
Teri
8/18/09 11:01am
Hi Teri,
There ARE others performing surgery on the occipital nerve area as well as the forehead and temple areas in order to eliminate migraine headaches. One such is Ivica Ducic, MD, PhD, at Georgetown University Hospital. This is micro-surgery, outpatient, and does not cost $70,000. (Neither does Dr. Guyuon's surgery.) Here is a link.
http://www.georgetownuniversityhospital.org/body.cfm?id=555836
8/18/09 11:04am
Thanks, Anna,
I know they're performing the surgery. The problem DK is having is getting the insurance company to approve it. Even though other surgeons are performing the procedure, they're not doing any clinical trials.
Thanks for the additional info,
Teri
8/17/09 5:11pm
DK,
Surgical procedures genrally get past the point of being "investigational" when multiple trials have been conducted and they have similar results. In this case, there has only bee one small trial done, and as you can see by our article, the medical community doesn't agree about it.
I'm really sorry, but I just don't know how to prove to your insurance company that they shoudl pay for this procedure without more clinical trials behind it.
Good luck,
Teri
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By DKOhio— Last Modified: 10/20/10, First Published: 08/08/09
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I appreciate the response and yes this is the surgery. Mine is going to be for the occipital nerve as well as turbinate surgery. Insurance has approved the turbinate surgery but not the occipital nerve surgery. When do surgeries get past the point of being investigational. Dr. Guyron has patients coming from around the world to perform surgery for different trigger points. How can I prove to insurance that this will save them money in the long run or that enough cases have been performed? Any suggestions? Surgery set for Sept. 17th.