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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #11  
Old 03-02-2006, 12:15 PM
Paul Paul is offline
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I don't know about that lower cost comment he made. I have not added up all the costs but my 2 level fusion is over 100,000 just doing a cursory glance at the insurance EOBs. That is what they are paying not what was actually billed. I don;t have the hospital bill in front of me right now but I recall just the rods and screws being more than what some have mentioned the charite disks are going for. I had cages as well which adds to the cost.

And yes, my major vessels were moved out of the way just as in ADR.
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  #12  
Old 03-02-2006, 02:17 PM
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Paul,

It would be great if you could itemize some of the charges for individual devices/component parts of your fusion. it would be great to see what was billed and what was paid for these parts since everyone seems to only complain about the manuf price for Charite, not what would actually be paid by an insurance company or CMS. There is always such a wide gap!
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  #13  
Old 03-02-2006, 03:12 PM
Mariaa Mariaa is offline
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It would also be interesting to be able to follow patient populations getting fusion to see the number that are back for more revision surgery and/or hardware removal, continuing Pain Managment treatment and so forth...

I've pretty much forgotten all the terminology for stastical studies but is that called a time continuance study or something like that when a segment of the population is followed throughout a span of time such as 20 years later...

When I read about fusions, it just seems like the majority I read about have continuing problems either because of non fusion at a level done (levels) or continued pain due to some factor ie nerve root scarring, SIJ problems, screws moving, adjacent level becoming problematic or some such thing.. and overall I would imagine that a great number of the fused population end up costing the insurance carrier a pretty penny with continued care ~

Of course I'm just reading about failed surgeries or surgeries with continuing problems that end up spine forums but I have to say that in the 8 years I've been reading at spine forums and waiting to make my next move with back surgery~ just in terms of persons posting here vs. persons I read about with fusions.. it just seems like I see a greater number of good outcomes than poor.. or improved outcomes.

I know that of course I've read about less ADR cases than fused cases so that probably makes a difference tho one thing I've not read about in fused patients over the years is the type of activities a good outcome fused paitient returns equaling what good outcome ADR patient returns to.. and I'm basically recalling younger population that were involved in similar activities..

So many things to consider with studies and what they show and represent and in what age and health population even race, and ethnic group.. I still cannot see making such blunt statements about a segment of the population that was just lumped into one big group.. Medicare recipients.

Who is to say that I may not be sicker or poorer off medically for what I might be denied.. no longer is the doctor in the driver's seat here.. unfortunately~
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  #14  
Old 03-02-2006, 04:29 PM
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If anyone can cite to examples Mariaa is referring to either in publications or personal experiences regarding fusion problems, please post them in the CMS public comments for this ADR decision. Their decison is not final yet...its still in the "proposed" decision stage.
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  #15  
Old 03-02-2006, 06:08 PM
sahuaro sahuaro is offline
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Maria:
In addition to collecting the data, we need to find out the "how" of applying the "civics lesson." When you speak with the reps of advocacy groups, please ask their advice on this and also what it would take for them to become involved. Remember that Deyo has the organized backing of private insurance companies. It would be interesting to know what the device makers are planning to do in response at this point. Despite Deyo's denial, this does affect more than the development of artificial discs--and will affect the development of other new devices, so the effects will be wide-reaching.
__________________
2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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  #16  
Old 03-02-2006, 07:13 PM
Mariaa Mariaa is offline
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Sahuaro,
Yes, will do. Agreed re far reaching effects~ wonder what about Medicaid/MediCal (for CA). Recipients are younger usually tho not necessarily in good health, and can be Medi-Medi.
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  #17  
Old 03-02-2006, 07:21 PM
sahuaro sahuaro is offline
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Some more thoughts:
(1) Does anyone know if the data presented to Medicare for approval of knee and hip replacements included elderly patients?
(2) I do know that osteoporosis is an issue which might preclude knee and hip replacements--when my gynecologist wrote my first prescription for Fossimax, she read my mind by commenting, "And don't think that when you break your hip, you can just get a replacement--there won't be any bone to attach it to." Similarly, the ortho commented after operating on my mother's broken ankle that there was hardly any bone to attach the pins to. So--if osteoporosis is an issue for these devices, why should Medicare adopt a different standard for ADR????
(3) Why wouldn't osteoporosis be an issue even in fusion, if hardware needs to be attached to bone? (I am posting this question on Spinal Roundtable). And if that's the case, Deyo's whole argument is spurious.
__________________
2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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