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Old 01-07-2012, 02:17 AM
Izzy Izzy is offline
Junior Member
Join Date: Jan 2012
Posts: 2
Default New Member

Hello everyone,

My name is Izzy and I recently underwent two level ADR surgery at Stenum Hospital in Germany. I had an auto accident in 1998 and had been suffering with four-level degenerative disc disease for over thirteen years. In March 2011 I decided to go Germany and I'm happy to report, my surgery was a total success.

Unfortunately, I am currently fighting Anthem Blue Cross for reimbursement of my medical expenses. I'm in the process of appealing their denial and I was wondering if anyone has been successful in getting ADR surgery approved that could assist me with some basic information. I would greatly appreciate the help.

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Old 01-07-2012, 08:35 AM
ouch2 ouch2 is offline
Senior Member
Join Date: Nov 2010
Posts: 163

Hi Izzy, Just wanted to say hi and welcome you. So glad to hear that your adr surgery was a success. I am having a one level at L5/S1 early February. What levels did you have done?

Sorry can't help you with your insurance issues, but hopefully some will chime in with their thoughts. Wishing you all the best!

41 years old
Back injury Spring 2010
Discectomy/Lami Summer 2011..unsuccessful
ADR L5/S1 Maverick L5/S1 Feb 6th 2012
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Old 01-07-2012, 03:13 PM
Jstuckey's Avatar
Jstuckey Jstuckey is offline
Senior Member
Join Date: Nov 2010
Posts: 305

Izzy welcome. Glad everything went well! Have you checked out the Insurance thread on this site? Lots of info...
Joey Sue - 50 years old
9/28/2011: Hybrid STALIF TT interbody fusion at L5-S1 and M6-L ADR L4-5 with Nick Boeree, UK - forever grateful to you Nick! Still doing great.
Prior to the fix: Severe DDD L4-5 and L5-S1 with moderate facet degen at L5-S1, but only mild facet degeneration at L4-5.
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Old 01-07-2012, 07:39 PM
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Cirobi Cirobi is offline
Senior Member
Join Date: Feb 2008
Posts: 415

Welcome to the forum! I echo the others in being glad to hear your surgery was successful.

As for insurance, definitely check the insurance forum to see if there's anything useful there. I can't really assist on that end as I was very fortunate to have insurance with a company that seems to support ADR over fusion, so the process went smoothly with them. Well... minus some goofiness when I was in PT but that was less an insurance issue and more a billing and practice merger issue.

Hope you find the info you need or someone familiar with your particular insurance sees your thread!

31 yrs old
Lumbar herniation L5/S1

- Did mild PT, some chiropractics and self regulated pain management since initial sports injury in Spring 1997.
- XRay and Bone Scan Jan/Feb 2007
- PT March to May 2007
- MRI Jan 2008
- Disco positive at L5/S1 Feb 2008
- ADR surgery at L5/S1 on June 23rd 2008 - Prodisc
- Recovery - so far so good!

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Old 01-10-2012, 12:12 AM
Izzy Izzy is offline
Junior Member
Join Date: Jan 2012
Posts: 2
Default Thanks for the warm welcome!

Thanks to all of you for the warm welcome and support.

To answer some of your questions, my ADR surgery was to cervical levels C4-5 and C6-7. I also had a fusion to level C5-6 back in 2001 but it only alleviated some of my symptoms for a little over three years.

Best regards,

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Old 01-10-2012, 07:52 AM
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jss jss is offline
Senior Member
Join Date: Nov 2009
Posts: 1,411


Congratulations on your successful ADR at Stenum, and welcome.

Getting reimbursed AFTER surgery is much more difficult than getting your carrier to agree to cover the surgery before hand. I say that because I've seen the latter happen, but never the former.

I worked for over a year for reimbursement before capitulating to a bad-faithed BCBS-TX. I've PM'd you my failed third appeal. It s a beautiful work of art, but in the end did me no good. Hopefully you'll be able to glean something useful from it.

Good luck, Jeff
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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Old 01-10-2012, 12:41 PM
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laid up doc laid up doc is offline
Senior Member
Join Date: Sep 2010
Posts: 775

i decided that it would cost me more to fight Aetna ahead of time and wait/argue, then to just pay and get on with my life... ie, be able to return to work. that is not everyone's situation, but it was mine and it has turned out exactly how i thought it would... returning to work 2/15!
US non-spine MD - laid up no more!!!
had recurrent annular tear L5/S1, failed everything
M6L done 10/19/11 w/ Dr Clavel getting back to my old self more and more every week! if my PM box is full

The content herein represents my professional thought and opinions in a general sense only; they do not constitute professional advice or services. if you need medical advice, please consult a licensed physician.
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