ADR Scheduled Nov. 26th I'm freaking scared

[adrigail]

Hi all.

Name's Mike.
Been living with small annular tear at L4-5 for about 10 years. Have done: Chiro, PT, nsaids, meds, stretching, accupuncture and so many epidurals I can't even count anymore. Paid is mostly in sciatic and left heel. Took 5 years to figure out it wasn't my feet, it was my back.
Fast forward to April 25th of this year, I was lucky (sarcasm) enough to be rear ended by a distracted 19 year old who thought it would be better to drive through me and my car at 35 MPH instead of stopping. Needless to say, this blew out the L4-5 tear and ADDED a new tear at C4-5.
I am currently scheduled for an ADR Nov. 26th at L4-5 and at some point in the future, will have the c4-5 replaced as well (depends on when/how I heal from surgery #1)

I found this site looking for info/support. My surgeon seems to be quality, has been managing my back care for 7 years. He has helped me put off any surgery and has been against doing anything other than conservative treatment....right up until the accident exasperated the damage.

Basically, I'm here to get as much additional information that I can. As noted by others, it's easy to find negative info/results, but harder to find success stories. I get that it's no different than anything else....people are far more inclined to talk about bad experiences than good ones. Also, I can see how someone would want to shut this chapter of their life quickly if they have successful surgery that helps their quality of life.

Believe it or not, my personal health insurance approved the lumbar ADR on the first submission, which I requested when I just couldn't deal with the pain/meds any longer.

As far as the neck ADR, we have no reason to believe they won't approve it as well, and there is also an "AT FAULT" insurance company on the hook based on the car accident.

My questions are:
Any success stories to share? Would you do it again? Am I right to be scared half out of my mind?
How do you answer the question "am I bad enough to need this radical invasive surgery?"

I would appreciate an ear, some detailed info and basically anything you would be willing to share.

Thanks in advance.

[Harrison]

Welcome, Mike. Sorry for the short reply: if you look in the post-op forum, you will find detailed recovery stories going back to 2004. You can sift through the topic titles fairly quickly, then drill down on the cases that relate most closely to yours.

Gotta run.

[BackPainAint4Sissies]

How did it go? How are you?

[adrigail]

How did it go? It didn't.

I got a "third" opinion from another surgeon with a good rep. It was his opinion that an ADR wasn't the option he would choose to repair my damage. In fact, he gave me a "less than 4 in 10 chance" that my pain situation would improve from an ADR. His recommendation was a fusion to completely stabilize the affected area. he believes that my facet joint is also contributing to the pain generation and a stabilization would have a greater chance at success.

This surgeon performs both types of surgeries, has an excellent reputation as well as the first surgeon. I struggled with what to do for about a week. Then I cancelled the ADR surgery. I can't in good conscience go forward when there are competing theories from solid, respected surgeons as to the best course of action.

Ironically, Surgeon #2 agreed with Surgeon #1 that I do need an ADR in my neck. For some reason my Insurance company denied this surgery, I'm currently appealing their decision. Neither surgeon can believe that my Insurance approved the lumbar replacement and denied the cervical replacement....apparently that is exactly opposite of how most insurance companies operate. The only theory is that the Cervical replacement is due to a car accident and my health insurance isn't willing to front the money when they know there is an "at fault" insurance company.

I may just have to wait until the arm-wrestling with the auto insurance is finished to get the surgical care I need.

None the less, I still have decisions to make regarding my low back, my health insurance company is willing to extend it's approval of the ADR surgery to give me some time.

Bottom line? I think I know less now than I did a month ago......

[Lillyth]

You must have Cigna. That's how Cigna do. They LOVE the lumbars, and won't do the cervical. Ever. It's a board decision. Which is shaped by the lumbar specialist who heads it.

[BackPainAint4Sissies]

Originally Posted by adrigail

How did it go? It didn't.

I got a "third" opinion from another surgeon with a good rep. It was his opinion that an ADR wasn't the option he would choose to repair my damage. In fact, he gave me a "less than 4 in 10 chance" that my pain situation would improve from an ADR. His recommendation was a fusion to completely stabilize the affected area. he believes that my facet joint is also contributing to the pain generation and a stabilization would have a greater chance at success.

This surgeon performs both types of surgeries, has an excellent reputation as well as the first surgeon. I struggled with what to do for about a week. Then I cancelled the ADR surgery. I can't in good conscience go forward when there are competing theories from solid, respected surgeons as to the best course of action.

Ironically, Surgeon #2 agreed with Surgeon #1 that I do need an ADR in my neck. For some reason my Insurance company denied this surgery, I'm currently appealing their decision. Neither surgeon can believe that my Insurance approved the lumbar replacement and denied the cervical replacement....apparently that is exactly opposite of how most insurance companies operate. The only theory is that the Cervical replacement is due to a car accident and my health insurance isn't willing to front the money when they know there is an "at fault" insurance company.

I may just have to wait until the arm-wrestling with the auto insurance is finished to get the surgical care I need.

None the less, I still have decisions to make regarding my low back, my health insurance company is willing to extend it's approval of the ADR surgery to give me some time.

Bottom line? I think I know less now than I did a month ago......

With regards to your facet joint, have you ever had an intra-articular facet injection or a medial branch block? I recently had the IA injection and the pain went away, completely, but for only about two hours. I have to call the doctor this week to see what his thoughts are for the next step.

All the best!!

EDIT: Maybe you know this or you've already done it, but getting either of those injections may be able to rule out (diagnostically) the pain or the level of your pain at the facet joint...esp. since it sounds like he thinks (but doesn't know) the level of contribution/contributing pain. I hope that made sense.

[adrigail]

I have had Facet injections, like you, received only temporary relief. Actually, all my injections produced good but temporary results.
It will be interesting to see how this plays out. My good friend is about 6 months from a c6-7 replacement and is having all sorts of problems. He "claims" his pain level is higher now than pre-surgery. I personally think he is having med problems. But it really makes me wonder, having him be 6 months ahead of where I would be with the exact same problems/surgery.

[adrigail]

I do have Cigna. So you're telling me that I'm going to get denied on the cervical appeal? I actually will find out on Thursday, the 45 day appeal period ends on Weds.
If your information is correct that a Lumbar Specialist heads the board, I might take a little issue with that.
The only thing in my favor is that my Company self-insures and "allegedly" all appeals go to a review by an independent reviewer who makes a decision separately from Cigna. Guess we'll see if that's true.