Law Suit

[go*big*red]

Well, I guess the thing that upsets me most is this is the crap that could very easily "scare" the insurance companies into NOT covering them.

I'm not at all changing my decision of continuing to try to get mine approved and go forward. Sometimes this society we live in any more urks me, that's all.

[Kim]

I personally dont see that the insurance companies need any more fuel to thier fire they have us over a barrel as it is.
Hey maybe we all need to get together and start a class action suit against the insurance companies for denying us the medical care we need!
Then the attys could be doing something good for a change instead of suing J#J
What do you think of that??????????

[spotty14]

That sounds like a good idea since the insurance companies are making a profit by collecting premiums and denying medical treatment, and spending money that should be allocated for medical treatment on legal fees to fight the insured.

[Alastair]

From Medscape


Variation in Surgical Decision Making for Degenerative Spinal Disorders. Part I: Lumbar Spine
Posted 10/27/2005

Zareth N. Irwin, MD; Alan Hilibrand, MD; Michael Gustavel, MD; Robert McLain, MD; William Shaffer, MD; Mark Myers, MD; John Glaser, MD; Robert A. Hart, MD

Abstract and Introduction
Abstract
Study Design: Survey-based descriptive study.
Objective: To study relationships between surgeon-specific factors and surgical approach to degenerative diseases of the lumbar spine.
Summary of Background Data: Geographic variations in the rates of lumbar spine surgery are significant within the United States. Although surgeon density correlates with the rates of spine surgery, other reasons for variation such as surgeon age and training background are poorly understood.
Methods: A total of 22 orthopedic surgeons and 8 neurosurgeons of varied ages and geographic regions answered questions regarding the need for surgery, surgical approach, and use of fusion and instrumentation for 5 simulated cases. Cases included: (1) multilevel stenosis without deformity or instability, (2) degenerative spondylolisthesis with stenosis, (3) isthmic (spondylolytic) spondylolisthesis with foraminal stenosis, (4) degenerative scoliosis with stenosis, and (5) recurrent stenosis following prior laminectomy without deformity or instability. The effects of surgeon age and training background on surgical decision making were analyzed using an independent samples t test and Fisher exact test, respectively.
Results: Significant variation in treatment approach among surgeons was noted for all cases except the patient with lytic spondylolisthesis, for whom all surgeons recommended fusion. Orthopedists recommended fusion and instrumentation more often than neurosurgeons for all cases, reaching significance for degenerative scoliosis with stenosis (P = 0.02 for both fusion and instrumentation). Younger surgeons were generally more likely to recommend instrumentation than their older peers, reaching significance for multilevel stenosis without deformity or instability and recurrent stenosis following prior laminectomy without deformity or instability (P = 0.05 and 0.01, respectively).
Conclusions: Variations in surgical approach to lumbar degenerative diseases may depend on a patient's clinical condition. This study found strong agreement in the approach to lytic spondylolisthesis but significant variation for other degenerative conditions of the lumbar spine. In addition, recommendation for fusion and instrumentation varied with surgeon age and training background. Previously documented geographic variations may result in part from a lack of consensus on appropriate treatment techniques for specific lumbar degenerative conditions, as well as surgeon-specific factors.

Introduction
Significant variations in the treatment of many clinical conditions exist among American physicians. The rates of procedures such as coronary artery bypass grafting, hysterectomy, prostatectomy, and the treatment of acute myocardial infarction have varied with geographic location by as much as 10-fold.[1-6] Geographic variation has also been observed for common orthopedic procedures, such as knee arthroscopy, and shoulder, hip, and knee arthroplasty.[6-10] Similarly, the rates of elective spinal surgery for degenerative conditions of the lumbar spine vary greatly,[11-14] with rates of laminectomy and lumbar fusion showing nearly 7 and 10-fold differences, respectively.[7]

The rates and types of lumbar spine surgery have been shown to correlate with overall spine surgeon density. It has been suggested that patient factors, including age, lifestyle, patient expectations, insurance status, and overall health status, may also contribute to this variation.[14-16] However, it is unlikely that these factors completely account for all observed differences in the rates of lumbar spine surgery.[14,15] Factors inherent to individual surgeons' backgrounds, such as surgeon age and type of spine surgery training (orthopedic vs. neurosurgical), may also affect their approach to specific clinical problems.

Clinical uncertainty, which exists when there is no documented superior approach to a specific problem, may affect the basis of decision making in clinical practice. Clinical uncertainty exists in several aspects of lumbar spine surgery because many conditions have multiple treatment options with reported success.[12,17-29] Such uncertainty causes increased reliance on training and clinical experience, and may further contribute to observed treatment variations.

Examining differences in surgeon decision making regarding specific clinical scenarios may help elucidate factors contributing to documented variation. The Purpose of this study was to examine the extent of variation in treatment decisions among spine surgeons for 5 specific clinical scenarios involving degenerative conditions of the lumbar spine. We also sought to assess the importance of surgeon-specific factors, such as training background and surgeon age, as predictors of surgical approach to the individual cases presented.

Hello "Big Red"

I understand you had ADR and the disc use was Maverick. Could you tell me what you know about this specific disc?

Thks, Rosie