Riskier surgeries for back pain raise costs

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snobrdgrl321
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Date Joined Jul 2009
Total Posts : 278
   Posted 4/7/2010 7:05 AM (GMT -7)   
Interesting..........
 
Study: Riskier surgeries for back pain raise costs
 
 
Donna
Tethered Spinal Cord~1.5x1.2 cm spinal cord cyst at L5/S1  (Lumbar Laminectemy completed 9/10/09)~Scolosis~Migrains~Leg Deformity~Foot Deformity~Knee, Hip, Back, Neck Pain~Severe Depression~Insomenia~DDD~Artheritis (Spine)~Spinal Bone Spurs~NEW: Herniated Disc T5/T6 
"I'm not going to vacuum 'till Sears makes one
you can ride on"
~Roseane Barr~
 


Snowbunny21
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   Posted 4/7/2010 7:39 AM (GMT -7)   
I just read that article on MSNBC news...very interesting...My Neurosurgeon and PM who is an Anesthesiologist as well as the whole team at their spine institute have signed to not get any kickbacks. As well as they do not push any surgery and use minimally invasive procedures along with PT, and other modalities as much as possible with every patient.

Thanks for potsing this..It's so important that we do as much research and have as much knowledge about what is going on with our own health as well as news about the specific fields of medicine within our illiness/disease...
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Dec 2006
 
 


BethW
Regular Member


Date Joined Mar 2010
Total Posts : 132
   Posted 4/7/2010 8:40 AM (GMT -7)   
I was happy and sad when both neurosurgeons I have gone to told me there was no surgery for my problem. I mentioned that to my PM, and he smiled and said that he was happy that there are surgeons out there who don't cut first, ask questions later. I did mention to my "new" neurosurgeon that if the FDA ever approves multi-level disc replacement, I want to be at the top of the list.

It reminds me of an episode of ER WAY back when. One of the residents was trying to decide what specialty path he should take. He pointed out that "To a surgeon, cutting cures everything. To an internist, medication cures everything." Or something like that. I can't remember the quote. It sounds about right, though....
DDD (4 levels- L2-3 thru L5-S1)


Screaming Eagle
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   Posted 4/7/2010 9:18 AM (GMT -7)   
Pretty good article, and I for one felt like I had made the biggest mistake of my life after my surgery, but it is getting better every day though. I would however, suggest doing everything possible to avoid surgery first, and only do it as a last resort. This is just my opinion only, and only mine. The healing process from a full fusion is a really long time, and it can play with your head. The problem is also, that a person may not know for several if not weeks if it was a success.

I have gotten my first major surgery out of the way, and if successful, may influence my decision to have my neck fused as well for the same reason. The unknown is the culprit that keeps nagging at the heart and mind.

SE
DDD (Degenerative Disk Disease) S1-L4-L5, Heart Attack 2002, Angioplasty to clear blocked Artery and to implant Stent. Six Epidurals, Disocgram, Melanoma Cancer 07, Lumbar Fusion March of 2010, Four cortisone injections Tendinitis in Elbow.


Jim1969
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   Posted 4/7/2010 10:33 AM (GMT -7)   
I have read a few versions of this article in the last day or two, and combining them all there seems to be at least 3 issues here.

1. Having surgery at all.

2. Having more complex surgery when simpler ones would work just as well.

3. Older people being put under the knife when other therapies would would work better and eliminate complications which they are more prone to.



IMHO the reason for this push to have surgery is multifaceted. At one point you have doctors who are believing their own press and think they must fix everything or at least try to. At another you have the money factor, and then you have this on going and growing fear of long term pain medicine use.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1559
   Posted 4/7/2010 10:49 AM (GMT -7)   
You know, I was just thinking about this last night. My sister is having troubles with her back as well and her ortho wants to do a laminectomy on L4. Of course she called her sister to get some advice, but as I told her I would do every other thing before going through surgery first.

Anyway her surgery is scheduled for next week

Hugss

Scarred
I live to "Tame My Pain!" 


Chartreux
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Date Joined Aug 2006
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   Posted 4/7/2010 11:27 AM (GMT -7)   
Another thing that this article mentioned "what about the successful outcomes?" nothing is listed for outcomes...
Scarred, you might want to send this article to your sister and that I've heard that "once surgery always surgery..."
kinda that a laminectomy can lead to a fusion, ect...and that maybe she should go for a second opinion....
Really makes you wonder eh....
A good article but needs to list outcomes...
**********************************************
* Asthma, Allergies, Osteoarthritis, Spinal Stenosis, Degenative Disc (Lower Lumbar S1-L3 and Cervical C5,C6, C8 and T1), Fibromyalgia, Gerd,
Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

********>^..^<********>^..^<********>^..^<********


Jim1969
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Date Joined Jul 2009
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   Posted 4/7/2010 12:20 PM (GMT -7)   
Chart you are right. Outcomes would be nice to know....so long as they are true.


When it comes to back surgery, at least for repairing common back issues, it seems like the medical community tries to give a 90-95% success rate, but of all the people I have ever talked to who has had surgery it seems like it is a 90-95% failure rate.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 4/7/2010 1:21 PM (GMT -7)   
Jim & Char,
You both hit the nail on the head with "outcome data" issues. Having a fusion be "successful" and having it eliminate the pain the patient was trying to eliminate are two different things. I doubt that's measured in ways that differentiate both aspects. For me, my double lumbar fusion would be considered "successful" in that I fused fine, but it did nothing to relieve my pain. As a matter of fact, now I have more annoying lower back pack around the area of the incision.

PaLady

Screaming Eagle
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Date Joined Sep 2009
Total Posts : 5005
   Posted 4/7/2010 3:23 PM (GMT -7)   
I'm wondering how my fusion will turn out also, and will not know for quite some time. I feel better every day, but still have some lower back pain and the worst is the incision pain. Does anyone know when the fusion starts?

SE
DDD (Degenerative Disk Disease) S1-L4-L5, Heart Attack 2002, Angioplasty to clear blocked Artery and to implant Stent. Six Epidurals, Disocgram, Melanoma Cancer 07, Lumbar Fusion March of 2010, Four cortisone injections Tendinitis in Elbow.


Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1559
   Posted 4/7/2010 3:46 PM (GMT -7)   
Oh I totally agree. I often wonder if I would have done these surgeries IF I have known what I know now. Probably not. I have Char, told my sister to really think hard as to whether she is really ready to go down this road. She, IMHO needs to slow down and think hard about this. But, I can't tell her what to do and she is determined to go through with this surgery.
I live to "Tame My Pain!" 


Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 4/7/2010 4:40 PM (GMT -7)   
I totally agree about the difference between having the surgery for mechanical issues and pain issues...The Neurosurgeon where I had my 3rd cervical fusion (360), was very honest with me that we had to go back in this last time to repair immediately the damage that was done by the 2nd surgeon..and that it wasn't going to have any major reduction in pain at this point..I was extremely grateful for that honesty..

When I had my first surgery..I truly thought that I was fixed forever...that Dr...who was head of Neurosurgery...was fantastic..but didn't discuss those things with me that there could be failure...maybe because I was early 30's and didn't smoke..he thought the odds were better...but my bone, which was from my hip..didn't herniate...it actually disappeared....reabsorbed back into my body....happens in a small percentage of people...so the spine collapsed on itself in those two levels...

I do try to tell people to have this surgery as the very last resort..and that the research shows it's only 50% effective for pain...that they should go in eyes wide open...I didn't even know until reading the boards that this was an elective surgery for some people...that is really interesting to me...

For me..I won't have another one unless not doing so would cause permanent damage and my Dr. insisted it was medically necessary..just like my other ones.


SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Dec 2006
 
 


Scarred_for_life
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Date Joined Jul 2008
Total Posts : 1559
   Posted 4/8/2010 7:06 AM (GMT -7)   
You know one of my sister-in-laws had fusion surgery. Almost just like mine, but her neurosurgeron was a real you know what. He told her after her surgery, when she complained that her pain was still the same, that she was lying it couldnt be as horrible as she said it was. He told her that she had her back fixed by GOD and that her fusion was as perfect as he was. OMG I couldn't believe that she didn't sue this guy!!!

Just goes to show.....watch what doc's ya get as well.

Scarred
I live to "Tame My Pain!" 


Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 4/8/2010 7:13 AM (GMT -7)   
Yep...that was my 2nd surgeon...he told me that I shouldn't need any more than a Tylenol while I was in the hospital the morning after my surgery being discharged!!! Same words.."I fixed you, you should be fine"....I did end up reporting him the our State Medical Board...along with the PM that sent me to this guy since they wouldn't treat me after the surgery either...

That is why I feel so blessed to have the Neurosurgeon and PM now!! It's so important for people to not take that kind of cruelty and terrible medical treatment!
SB and "the pup who snores loudly" 
 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Dec 2006
 
 


White Beard
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Date Joined Feb 2009
Total Posts : 3611
   Posted 4/8/2010 8:27 AM (GMT -7)   
Well the first time I had surgery I was in the military in Alaska, I was the Branch Chief of the A-10 Flight Simulator, I knew absolutely nothing about herniated disk or back surgery or any of that! All I knew was that I was in pain, and it was a type of pain I had never ever had before and nothing they did or any thing they gave me, helped make the pain go away! We did not have a hospital on base, just a clinic, and the Army Hospital was 30 or 40 miles away at Ft. Wainwright in Fairbanks, and their Orthopedic specialist said I was malingering! When I finally had the surgery several months later, down in Anchorage, at the Civilian Hospital, ( it was considered an emergency as my spinal cord was in the shape of a sideways "U" in my neck ) Anyway I had a rough time of it after my surgery as I completely lost my voice for over 3 months after the surgery! Remember this was is in Mardh of 1985 and I had the Anterior approach done C6/7 ACDF ( they went through the front of my neck) that was literally a brand new way of doing that surgery back then! and they took the bone out of my pelvis for the fusion, and they did not use any hardware to keep it all in place! I just wore a Cervical collar for 5 or 6 months! Anyway I had many many problems for along time after I had the surgery, and I did not know why, nor did any one else! ( remember these are Military Doctors!) After quite a few years things seem to have settled down and I thought I was OK! No one ever told me that when you have a Disk fusion that the disks above or below the fusion would probably go bad sometime in the future!. With that said I had no choice at the time that I had my surgery, and it was more or less a life threatening situation. It did relieve the pain in my arms, which, at that time I would have done anything to have that taken away!

Now fast forward to last fall, and again I was having severe pain in my left arm, and I was told I needed a C5-6 ACDF, I knew my neck was a mess! as is my entire spine, with Thorasic Disks bad that no one will touch, and the Thorasic disks put me on disability and on constant pain meds! But back to C5-6, I again had the fusion done, and although I have still have allot of problems with pain in my neck and back of head,( caused by C2/3) the pain in my arm was gone right after the surgery and again I am Glad that I had it done!

Now with all that said I do realize that the article was mainly talking about lower disk problems, which I also have L4/5 disk is herniated and I have stenosis at L1 though L5. I am hesitant to have any type of surgery done down low, and so far I have been able to avoid it! Anyway if you need to have disk fusions done, the Anterior approach makes the most sense! The main part of the vertebra and the disks are in front of the spine, and the easiest way to get at them and do a fusion with the least complications is the anterior approach! ( going through the front)Unfortunately the Cervical Disk are the only ones that are available to easily do this to! Even my surgeon said that the cervical disk fusion is the easiest surgery to perform of any of the back surgeries! It is to dangerous to do this with Thorasic disks! ( Good thing that it is rare that they go bad anyway!) and Lumbar disk are really not accessible for this type of surgery! But yet Lumbar Disk are the ones that most people have the most problems with and are the ones that require the most surgery! I believe that is why so many people have dificulity after having disk surgery on their Lumbar Disk! The way the surgery has to be performed, and the healing time is longer too! I would have to agree with the article that just removing the bone and decompressing the nerve roots, makes allot more sense, if that is all that is needed, and as the article also points out, this type of surgery has the least amount of problems associated with it!
Anyway these are just my thoughts and rambling about it!

White Beard

Mrs. Dani
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Date Joined Jun 2009
Total Posts : 2787
   Posted 4/8/2010 9:25 AM (GMT -7)   
 
 
     Dear Donna,
 
     WOW! You have had my husband and I talking about this article for hours now! I can't thank you enough for sharing it with us. It raises for very good questions. I too, wish they had also determined weather the various types of surgeries were sucessful at relieving pain.
 
     I am glad that the new health care law has provisions reguarding financial ties to doctors. Though I had heard from word of mouth (social) that this stort of things happened, I never thought it to be true (IE: pharmaceuticals and Physicians). What an eye opener. I am shocked, appauled, and grateful you shared this article. My nievate reguarding this embarassing. Needless to say, I appreciate the knwoladge very much.
 
*hugg*
    dani
 
   

 

 

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood

 

 


PAlady
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Date Joined Nov 2007
Total Posts : 6795
   Posted 4/9/2010 1:50 PM (GMT -7)   
Bumping this up for a new member, Johnny.

PaLady
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