No Osseous integration with the bone (after TLIF)

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Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 9/9/2010 8:47 AM (GMT -7)   
Hello All,
 
I finally got a copy of my test results and reports from my ortho today and they were pretty bland other than the one statement that said "I do not see any significant osseous integration with the bone."  rolleyes It also says that I had the fusion and that the kind of technique I had does not use an interbody cage and has a slightly lower chance of solid fusion accross the disc space.   (The CT, x-rays and MRI's were all considered unremarkable as read by the hospital radiologist).
 
It further says that the hardware is Ok and that I am more comfortable proceeding forward.  Then it goes on to say that the best solution woull be to just live with the pain going forward and, if ever I felt like it got to be more than I could handle, we could always do an anterior lumbar interbody fusion by taking out the interbody space, using the prior surgery and placeing a graft.
 
Lastly, he states he does not think this would be needed in the near term, nor that is is medical necessity if I can live with the pain.  They will see me back on an as-needed-basis.
 
Does anybody know what this REALLY means for me?  I'm kind of at a loss here. All tests look like I'm just whining about everything and that I'm fine, but this looks a little different. eyes He clearly told me that this is where my pain is coming from.
 
I also need to know whether or not to send it on to SSD for them to consider when making their final ALJ decision.
 
Thanks again guys! 
Retired Mom

Post Edited (retiredmom) : 9/9/2010 6:51:51 PM (GMT-6)


straydog
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Date Joined Feb 2003
Total Posts : 13470
   Posted 9/9/2010 12:43 PM (GMT -7)   
I would not think it would be a good thing to try and withhold info to them. The drs records are going to reflect the testing was ordered.

Susie

Retired Mom
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Date Joined Feb 2010
Total Posts : 1753
   Posted 9/9/2010 5:59 PM (GMT -7)   
Hi Straydog,

I guess it sounded like I was trying to withold info...on the contrary, I'm wondering if it would be beneficial to send on this paperwork because it shows that the bone did not grow as it was supposed to and did not fuse. It's a confusing thing and I'm still waiting on the lawyer to make her decision to take my case or not. I'll be sending them a fax tomorrow of the Dr's I've seen, the procedures I've had done, and anything else medical possible even as early as tomorrow afternoon. I'm just waiting to hear what the new reumy has to say tomorrow. I don't want to all of the sudden have a hearing date set and not have followed up. I can't depend on the attorney until I get an official decision from her office as to her acception or rejection of my case.

My main point, though, was about the wording of the report and what it all means in layman's terms. This medical jargon gets me lost.

Thanks for the info, though. I really do appreciate it!

You're awfully kind to keep answering questions for those of us in the process of this SSD nightmare.
Retired Mom

mrsm123
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Date Joined Dec 2007
Total Posts : 1228
   Posted 9/9/2010 8:25 PM (GMT -7)   
Hi Retired Mom,
It means that there isn't any significant bone growth in the area that you had fused. My first fusion didn't take and I am not too confident that the 2nd/revision did either. If the hardware is in place and appears solid than it really isn't an emergency to do a revision and try to re-fuse the area, although it would be wise to keep an eye on it. Your doctor may offer to get you a bone growth stimulator ( I can't recall how long ago your surgery was done) if it is not too long ago. I have known doctors to order them in fusions that don't appear to be fusing up to a year or 18 months out to try to get the bone to grow and sometimes it does work.
The recommendations seem to say that while there isn't much in the way of new bone growth, and there doesn't appear to be nerve compression or bone overgrowth,  he doesn't feel that right now, there is a medically justifiable reason to go back in to try to do a revision surgery since the hardware seems to be in good shape. He seems to feel that managing your pain with medications is the way to proceed from here on out until or if your pain increases significantly to the point that you can't treat it with medications then it might be time to revisit the revision surgery option.
Does that help?
Sandi
 

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13470
   Posted 9/10/2010 2:03 AM (GMT -7)   
RM how long has this atty had your paperwork to review? Two weeks should be ample time for the atty to review your paperwork. Keep in mind you have 60 days to appeal the decision so please do not let time slip by. I was a dead line nut when I worked. I made sure all of my dead lines had been met well in advance. I had a long credenza in my office and it stayed full of stacks of medical that was copied from my files with notes attached. I never wanted to be standing at a copy machine copying 2-3 years worth of medical on the last day, lol. For some things I did my own copying rather than have a floater do it, I knew if I did it I had all of it copied. I honestly cannot remember when you contacted the atty.

Susie

Retired Mom
Veteran Member


Date Joined Feb 2010
Total Posts : 1753
   Posted 9/10/2010 3:54 AM (GMT -7)   
Thanks so much to you all. 
 
Mrsm,  that was exactly what I was looking for in an explaination.  I appreciate the time you took to work on that.
 
Susie,
 
They have had my signed request since JULY.  They did electronically file for my hearing (which I have verified and do have a copy of).  Then they order a disc from SS, but SS wouldn't give it to them since they didn't submit the official copy of the representative form that I signed.  Apparently they review your medical records first before deciding to take the case or not.  Anyway, I asked for and recieved the disc from ssd and took it to them for copying.  They made a copy and it was printed out for the attorney to review last week.  Apparently she has hit some major court time this week and is supposed to have next week fairly free to look at cases and decide.  I would  have given up on this office a long time ago, but I signed for her to take my case and have spent a pretty decent amount of time on the phone with her clerk updating medical information and trying to obtain the documents they needed from ssd.  I also understand she is the best in the area, so that is why she is so thorough, but either way.....it's time to move.  I know I met the deadline to file for the ALJ hearing, but I don't want to go in without representation and I don't want to be hunting a lawyer at the last minute.
 
I really do appreciate all of your help!
Retired Mom

mrsm123
Veteran Member


Date Joined Dec 2007
Total Posts : 1228
   Posted 9/10/2010 8:57 PM (GMT -7)   
Hi Mom,
Glad that I could help. I hated not having someone who could explain things to me when all of this mess first started, so I learned the hard way what things meant and what it would mean down the road when it came to MRI's , CT scans and the like, along with learning what doctors are really saying when they give us those huge words that no one can understand.......LOL
Hope you are feeling a bit better, and the pain is less.
Hang in there,
Sandi

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 13470
   Posted 9/11/2010 12:28 PM (GMT -7)   
RM was your denial on the Request for Reconsideration? If so, then that would have been denial number 2 then you can ask for a hearing. I did not realize you were that far a long on your claim. Hopefully next week you will have your answer from her or someone in that office. I can't imagine stringing a potential client a long that length of time, that would bother me. As long as the proper letters are sent in on your behalf to preserve the claim that is an important part. Here in Tx you cannot request a hearing before an ALJ until you have been denied on your Request for Reconsideration which is the 2nd denial. Didn't want to confuse you on that one.

Susie
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