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Old 03-05-2011, 04:14 PM   #1
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Question Spinal endoscopic/laser surgeons in northeast?

Hi,

Iím new to the forum but have done some on-line research. Iíve had back pain for 27 years and sciatica for 22. The last 3 years the sciatica and back pain have become unbearable to the point of losing my job and collecting SSDI. Iíve seen many doctors ini an effort to get some pain relief. Theyíve all told me the same thing. ďTake Ibuprofen and go to PT.Ē Iíve tried both of those and chiropractics to no avail. Because of this I was "Doctor Shopping" and I suspect some didn't believe me because of the popularity of these drugs nowadays for recreational use. Two doctors told me that they can get in too much trouble by the DEA so they avoid prescibing narcotics. They suggested I buy them off the street. I couldn't believe they said that. I'm clean cut and just retired from 20 years of law enforcement. I told them I didn't want to get arrested. I normally don't break the law but my job was at stake and I was getting little to no sleep most nights because of the pain. I asked around and found out that oxycodone, percoset, etc. goes for $1 per mg. That's a lot of money. I am actually considering buying some at this point but probably won't, only because they cost a fortune. I did buy some codeine on line but it had to be fake because it didn't relieve the pain one bit.

I went to a pain management specialist 1.5 years ago and he helped me a lot. Iíve had several MRIís done and they show severe lower scoliosis, marked stenosis, disk herniation, degeneration and bulging. I also had a spec scan done and my facets are in bad shape. The PM doctor has given me 9 cortisone injections to the low back and two to the neck. They got rid of much of the sciatica, although it always pops up in a different place later. The injections also improved the range of motion in my lower back.

Now my major problem is that I canít walk more than 50 yards before having to sit down in severe pain. I suspect thatís from the stenosis. Does anyone know if 9 low back cortisone injections in 1 year are too many and can make things worse? Doctors make $$ for every injection. He's a decent guy but I've heard doctors don't make as much money as they did, say 20 years ago. Many don't even make over 100K.

I saw a neurologist regarding a laminectomy, as suggested by my pm doctor. He told me I need a spinal fusion from my neck to lower spine. He said the odds are that it would fail so heís not doing it. Basically he told me, in a nutshell, that itís something I have to live with the rest of my life.
Iím only 50 and canít live like this the rest of my life. Whenever I go shopping, I have to use a motorized wheelchair as I can't stand or walk more then a few minutes. The narcotics no longer work and my doc refuses to give me an increase. Iím on 90mg/day oxycodone and 32ml/hr of the fentanyl patch. Does anyone know of anything I can take, eat or drink that will improve the efficacy of the narcotics. As I said I've been on fentanyl patches for close to a year. Only one time did I experience any pain relief and it only lasted a few hours. Does anyone know if some people have genetics that make fentanyl not work as good as it does in other people. I have asked my doc for an increase in the oxycodone and he sais that 90 mg per day is the max. amount allowed. That's an outright lie. From reading some of these pain message boards, many people are on much higher doses of oxycodone. I see him Tuesday and I don't want to accuse him of lying so I'm trying to think of a way to let him know that I know that 90 mg of oxycodone is far from the max. dose you can give someone.

I was talking with the Laser Spine Institute. After one of their docs looked at some radiologist's reports of MRIís, they told me they could reduce my pain by 50-80%. I was shocked to find out my insurance co. won't cover most of the costs. I was told that most insurance doesnít pay enough. Blue Cross and another one will cover almost all of the bill. They will take mine but mine will only pay, like 4K of the 23K it costs.

I would like to talk with another laser surgery clinic or any doctor that does laser back surgery. I live in Maine and have made many phone calls and spent many hours Googling but canít find anyone else in the northeast, except a man in NYC, whom Iíve read too many horrible posts about. There's a laser spine clinic in Texas but I'd rather stay nearby to keep costs down and to recuperate, if needed, in my home or a relative's.

[B][COLOR="Red"]If anyone knows any laser surgeons in the northeast would you please let me know? Also, if you know of anything I can take to make these narcotics relieve pain again, it would be appreciated.[/COLOR][/B] I asked my Dr. this same question and he said to switch to Vicodin for a few months. I did that and the first few days back on the oxycodone it did work better but around day 4 I was back to it barely relieving pain anymore.


Thanks

 
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Old 03-05-2011, 04:57 PM   #2
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Re: Spinal endoscopic/laser surgeons in northeast?

Would you be willing to go to Boston?

Jenny

 
Old 03-05-2011, 06:19 PM   #3
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Re: Spinal endoscopic/laser surgeons in northeast?

Jenny,

Sure I'd go to Boston. I live near Acadia. Way up there in Maine. It's a days drive but well worth it if they do minimally invasive, endoscopic laser spine surgery and my insurance will pay for it.

The next closest place is outside of Philly, TSI. My insurance will only cover about 4K of their 23K estimate.

I noticed you're from Conn. I also have relatives in Western Mass. You know any of the same type of surgeons in Springfield, Hartford, etc.? I've spent hours Googling but no luck.

 
Old 03-05-2011, 06:46 PM   #4
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Re: Spinal endoscopic/laser surgeons in northeast?

Why are you pursuing laser surgery rather than a more traditional surgery from a fellowship-trained spinal specialist that would more likely be covered by insurance?

 
Old 03-05-2011, 07:11 PM   #5
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Re: Spinal endoscopic/laser surgeons in northeast?

Sorry Sailor but I go to Boston too.

I can give you 2 suggestions but I don't know about the endoscopic laser surgery. But I know of one of the top spine docs in the world. It would be a good idea to be assessed by him and then have him refer you to someone who he thinks would be good if laser surgery would work(if he doesn't do it which he may). But with this guy, you get cutting edge surgery from around the world. The Japanese are miles ahead of us in non-fusion surgery to correct the spine and he is one of the main leaders of this type of surgery in the US.

So my surgeon is Dr. Eric J. Woodard, Chief of Neurosurgery at New England Baptist Hosp in Boston. NEBH is an orthopedic specialty hospital in the south end of Boston. They oversee the orthopedic care of the Celtics and many, many pro athletes. He is the former head of spine surgery at Brigham and Womens and teaches at Harvard.

I would also recommend the Boston Spine Group(have a website). They are a group of ortho spine surgeons who do some real cutting edge stuff with backs as well.

I broke my neck in 3 places and dislocated 5 vertebrae. I was paralyzed on the left side with some right sided paralysis as well. Then Woodard operated on me. I have a weak left arm but I can pick up my 35 pound granddaughter. I can walk and I can even run if my knees behave. I take nothing more than an occasional Tylenol for neck pain. That is the sign of one good spine surgeon...results!

He's hard to get in to see and the wait can be months long but I can't say enough good about him. He used to be with the Boston Spine Group so I trust them too but he is now the top doc at NEBH and they are equally good as a hospital. One of the lowest post-op infection rates in the US. Do some 5000 joint replacements a year with a post-op infection rate of .4% when the national average is over 2.5%. And they do the tough ones. Woodard will gladly give you all the stats on spine surgeries and recovery as he knows them. You might find that he has a better surgery for your problem.

Check the NEBH website for more info.

Jenny

 
Old 03-06-2011, 11:41 AM   #6
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Re: Spinal endoscopic/laser surgeons in northeast?

I'm exploring all options. I've had surgery on my rib cage before that got messed up big time. I'm not jumping into anything quick. I saw a neurosurgeon and he told me the only option is to have a spinal fusion the whole length of my back. He said "it's major, major surgery and the odds are it won't be succesful so I'm not doing it" He is an older man and I checked out his credentials on line. He has been practicing for exactly 50 years.

[B][I][COLOR="Blue"]I'm hoping he doesn't know what he's talking about[/COLOR][/I][/B] or doesn't keep up with modern techniques, being close to 80.

 
Old 03-06-2011, 11:59 AM   #7
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Re: Spinal endoscopic/laser surgeons in northeast?

Jenny,

Thanks. I'll see if he's covered by my insurance first, and if so, make an appt. I'm awaiting to see a neurosurgeon in Bangor that a doc told me was good. It takes 5 months to get a consult with her when the rest of them are about a month behind.

Glad to hear you've gotten a lot better and appreciate your help.

 
Old 03-06-2011, 12:19 PM   #8
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Re: Spinal endoscopic/laser surgeons in northeast?

Jen,

I thought of a few questions, if you don't mind.

1. Roughly how old is Dr. Woodward?

2. Do you know if you can specify Dr. Woodward to do the surgery?

3. Did they try to steer you toward another surgeon at the same clinic, who is maybe not so busy?

I did call that same hospital the other day because of a reply to a post I made on another board. The secretary told me they don't do laser/endoscopic surgery.
I had forgotten about that when I made my first reply to your post. My feelings are that he may be a good surgeon but I am really leaning toward the endoscopic/laser surgery. I have read some posts by others who have had that surgery that are really impressive.

 
Old 03-06-2011, 12:23 PM   #9
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Re: Spinal endoscopic/laser surgeons in northeast?

If your back is that bad, you need someone like Dr. Woodard. I've met some people he has fused the entire back and they are happy and can move very well. They do it in sections and with a new process that gives you some flexibility with rods down the back. In fact, my neck is done with just 2 rods. They are off the surface of the bone so I have some give and it makes the bone stronger too.

But you can't just pick the phone and call him. You need to have your doc send the MRI reports and any other reports you have as well as a physical exam report(my neurologist sent everything in for me). He then reviews the reports and if he thinks he can help you, will call and set up an appointment. If you need to be seen quickly, he makes the time. But if he can't help you, you don't waste your time coming to him, either.

So if you'd like to be seen by him, get your doc to send in the needed paperwork and a letter to him requesting a consultation. His office is at the NEBH.

If you need addresses or phone numbers, let me know.

Jen

 
Old 03-06-2011, 05:29 PM   #10
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Re: Spinal endoscopic/laser surgeons in northeast?

Where did you hear of him from? It's good that I wouldn't end up making an overnight trip there for nothing if he doesn't think he could help.

Thanks.

 
Old 03-06-2011, 10:04 PM   #11
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Re: Spinal endoscopic/laser surgeons in northeast?

Unless I've missed something, I don't believe you mentioned what is wrong with your spine. What do the reports indicate are you major problems?

When the neurosurgeon that has been practicing for fifty years was trained, fusion was the only option available. Every decade there have been huge advances in technology.

Your posts are puzzling to me because you talk about being told that your spine needs fusing and then say you want laser surgery....If your spine is damaged to the extent you indicate, there's no way laser surgery would resolve your issues...at least from what little I know about your spine, that's what I would suspect.

 
Old 03-07-2011, 08:34 AM   #12
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Re: Spinal endoscopic/laser surgeons in northeast?

The neurosurgeon looked at the CD from mri's from the neck to the lowest part of the spine. He said there is damage at every level. That is degenerated, herniated and worn discs along with facet damage. There is severe scoliosis at the bottom of the spine and it is twisted. He's not sure whether the scoliosis is a birth defect or occurred later in life alothough I guess that's a moot point anyway.

He said the scoliosis is causing pressure, which is causing the pain. I'm wondering that if the scoliosis is at the bottom of the spine, why does the entire back need a spinal fusion, in his opinion.

He may well have not have kept up with technology. He told me that the laser/spine surgery is a farce but at the same time he may not know anything about it.

THE ONLY PART OF MY BACK THAT HURTS IS THE L5-S1 AND THE NEXT FEW SECTIONS UP. The middle or upper back don't hurt at all. I was taken aback when he said my whole back is messed up and I need a spinal fusion of my whole back. I have already sworn off exercise if I ever get better, as I believe that was the major factor in causing this and is what caused the scoliosis.

I had sent a spec scan and mri reports to LSI. One of their docs reviewed them and said they could relieve my pain by 50-80%. I'd be happy with that but am trying to find a similar clinic closer to home then Philly. I live in Maine. Let me also say that the neurosururgeon is adamantly opposed to doing a spinal fusion of my whole back. I'm seeing my PM doc tomorrow who already has the neuro's report. I'll get his input.

Thank you.

 
Old 03-07-2011, 09:22 AM   #13
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Re: Spinal endoscopic/laser surgeons in northeast?

I am obviously guessing here, but I think most spine surgeons would be opposed to fusing your whole spine unless it was so unstable that there is no other option. They do not like to have to do more than two or three levels, as the chances for fusion drop significantly with the more levels that are fused.

I also feel strongly that with all your issues, you are not a candidate for any type of endoscopic, minimally invasive or laser surgeries. Laser surgery, at best, would be a temporary fix and would not address your most severe problems.

Most of the clinics that advertise as laser spine clinics are, in my opinion, procedure factories. The doctors do basically one procedure using a laser technique. They treat for the pain rather than trying to correct the mechanical issues that are contributing to the pain. So while there may be some relief initially, it is not long-lasting. They do not have the equipment or additional training to be able to perform more complex procedures if they get in there and see that the situation is more complicated than they had originally determined.

You will find that most of these clinics are located in Florida and Texas. The reason you are having a hard time finding one in your area is due to a bias against this style of medicine. Doctors are trained to use lasers as a small part of their surgical practices, but it is not emphasized as the primary method. Why would insurance cover a fusion that would cost upwards of $150,000 but not cover a $23,000 bill from LSI?

I look forward to hearing what your PM has to say tomorrow!!

 
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Old 03-07-2011, 03:32 PM   #14
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Re: Spinal endoscopic/laser surgeons in northeast?

Thanks for your input and advice. My PM doc told me I needed a laminectomy a few months back and the neurosurgeon sais I need a total spinal fusion of my whole back.

My main pain symptom is that it's hard standing up straight and walking for more then 50 yards, hence the use of motorized wheelchairs in Walmart. The PM doc sais this is from stenosis. He said a laminectomy should fix it.

I have an appt. with another neurosurgeon in 1.5 months. She was recommended by a nerve doc to me. I'm very curious what she will have to say. Supposedly she is quite good.

The low back pain increased about 1 year after I retired from the Coast Guard, three years ago. The first year I cut down trees all day, every day on my lot. but the pain didn't get real bad until about a year after I started the tree work. I used to do that for a living and never got anything more then sore middle back muscles. I suspect I was wearing down my facets, disks, etc. at the time and didn't know it.

 
Old 03-07-2011, 03:35 PM   #15
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Re: Spinal endoscopic/laser surgeons in northeast?

One more thing. From what you know, would you think I could get away with just low back surgery as that's where the only pain is, except for sciatica.

Do you have a medical background?

 
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