Scheduled for C5/6 ADR with a Prodisc-C--questions about that type of implant

[JinSong]

Well now my insurance company has actually denied the ADR authorization--I know it's a common thing to have it initially denied, but my surgeon had already written a letter with a detailed spine history and his recommendations for them. Since they denied that attempt, he's going to do a peer review with the insurance on Monday. I'm sure it varies between insurance companies, but has anyone else ever had this happen? I'm wondering how long it usually takes to get an answer once they do the peer review.

[JinSong]

Just to put a cap on this thread, the peer review rejection was almost instant, and then the third appeal was protracted. My surgeon's office tried to push for an expedited appeal, and that request was denied. After weeks of fighting, they didn't want me to wait any longer because I have progressive spinal cord symptoms. I go in for an ACDF tomorrow morning instead, and I am so, so upset. I wish I had a happier ending to my story.

[Harrison]

Jin, you'll be OK. We are here for you.

[JinSong]

Thanks Harrison--sorry that I'm going to be "out of the club" now. I'm just so depressed. I'm only 32, and this just feels like the beginning of the end. With all the adjacent segment damage potential, and the fact that my other discs are already having issues, I feel like it's just going to be a daisy chain of fusions by the time I'm 40. Even if I can get an ADR approved in the future, we know hybrid surgeries are not really validated. I feel like I'm permanently screwed (literally, I'll have instrumentation with my fusion). Plus the protracted ACDF recovery and the hard cervical collar for 6 weeks straight that I am not looking forward to don't help. I'm just so upset

[JinSong]

Ended up in the hospital for three days with the ACDF and it was pure torture. Recovery is not going well. I wish I could go back in time and un-do this, but they said my spinal cord was "dented," and this was the right thing to do, rather than wait for insurance to pass the ADR. This whole thing is a nightmare.

[pbrav]

JinSong, I am so sorry to read about your frustration and pain! I have been following your story with interest, and I have been impressed by the systematic way you have gone about looking for the best alternatives. I am so sorry you were not in a situation where you could choose the treatment you prefered. I guess this is not much comfort right now, but as a fellow academic I can assure you that you are not going to be a phd-student for ever - and your economic situation is going to give you much more freedom in the future. If you, as a worse case scenario, get problems with adjacent levels further down the road, you will most probably be able to choose the treatment you prefer - and you will be able to stop the deterioration with an adr of your own choice. I gather from your previous posts that you are a very resourceful person, and I am sure you will get out of this even stronger. I really hope your recovery will be less unpleasant soon, and I wish you all good luck.

[annapurna]

To add to pbrav's encouragement, there are a lot of new approaches that are being used to treat discs that are showing some damage but not enough to warrant surgical replacement. Stem cell injections are showing reasonable success for discs like that. You don't hear too much about them here because most people aren't in a position to pursue that kind of treatment: by the time there's enough pain to cause them to figure out why their back hurts, the damage to the disc is advanced and stem cell procedures would require more time than they have. For adjacent level damage, though, they do hold some hope. Laura had ACDT on her L45 years ago and hasn't had problems with it since.

[Fathub]

Originally Posted by annapurna

To add to pbrav's encouragement, there are a lot of new approaches that are being used to treat discs that are showing some damage but not enough to warrant surgical replacement. Stem cell injections are showing reasonable success for discs like that. You don't hear too much about them here because most people aren't in a position to pursue that kind of treatment: by the time there's enough pain to cause them to figure out why their back hurts, the damage to the disc is advanced and stem cell procedures would require more time than they have. For adjacent level damage, though, they do hold some hope. Laura had ACDT on her L45 years ago and hasn't had problems with it since.

Anna, I have never seen any verified studies of the effectiveness of Stem Cell injections other than the promotors thereof. Do you have any links to some bonafide studies?

[annapurna]

Originally Posted by Fathub

Anna, I have never seen any verified studies of the effectiveness of Stem Cell injections other than the promotors thereof. Do you have any links to some bonafide studies?

This is a bit bigger question than I can answer quickly. I'll try to post something under Regenerative Medicine as I can. Quick answer: blind studies, implying the control group's getting needles stuck into degenerated disks with no effort to treat them, would seem to be medically unethical as we know that casually injecting disks can lead to damage or accelerate the damage that's already present. That means we're probably never going to find a published, verified, statistically valid, blind study. You're more likely to find long-term studies discussing outcomes but not comparing those against any control group.

[Fathub]

Originally Posted by annapurna

This is a bit bigger question than I can answer quickly. I'll try to post something under Regenerative Medicine as I can. Quick answer: blind studies, implying the control group's getting needles stuck into degenerated disks with no effort to treat them, would seem to be medically unethical as we know that casually injecting disks can lead to damage or accelerate the damage that's already present. That means we're probably never going to find a published, verified, statistically valid, blind study. You're more likely to find long-term studies discussing outcomes but not comparing those against any control group.

So, statistically speaking from a purely science POV....it's snake oil at this point.