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Treatments for Lumbar Disk Tears?

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Old 10-28-2002, 07:21 AM   #1
Join Date: Oct 2002
Location: Chicago, IL USA
Posts: 4
calip HB User
Angry Treatments for Lumbar Disk Tears?

I have been reading these boards for sometime now, and just now asking for advice. Go figure!

I have been diagnosed with a L5/S1 Grade 3 annular tear. My Orthopaedic Surgeon seems to think it tore or has been aggrevated by my Irritable Bowel Syndrome (which can give me severe constipation -yuck, sorry! and requires me to push, therefore putting pressure on my disk). I have had many neurological tests done: MRI's of cervical, lumbar, and thoracic (I also have a small central herniation at T7/T8- which they want to deal with after the lumbar area is fixed- they think some of the pain is from the leakage of the lumbar tear); Myelogram with CT and a diskogram. I have tried many medications (anti-inflams, muscle relaxers, pain meds (the only one that works is Vicodin HP (high potency). I have a tens unit, I try ice and heat...EVERYTHING!

So, here is my problem, my Orthopaedic Surgeon wants to do IDET...the insurance won't cover it or any complications thereafter. The ins. Company (BC/BS) says that a diskectomy is more effective than IDET. I have asked the DR's office to appeal to the Medical Board of BC/BS to try to get this procedure approved based on the fact that it is a tear and doesn't need removed or replaced and that I am a 27 y/o female. I will have to wait 30 days to get a judgement.

In lieu of IDET (for now)-I just had an KLM injection into L5/S1(it's Kenalog (anti-inflam), Lidocaine (short term anestetic) and Marcaine ("long term" anestetic)- Dr. hopes that will help me cope with my pain. That was 3 days ago and nothing is different. I can only relieve my pain with Vicodin HP, and sometimes with my cane as needed. I have to sit on an shower stool to take a shower sometimes, I can't go anywhere execept to the doctor and have been out of work (with sick pay,thank god) for 3 months. I was so relieved to hear about IDET, and now so incredibly discouraged because I can't get it fixed.

Has anyone heard of any other treatment options other than IDET to fix a tear? The insurance co. will not cover anything like IDET!

Should I look into going to a Neurosurgeon? I have seen a Chiropractor, Neurologist and an Orthopaedic Surgeon. They are all top in their field (in Chicago), and are highly recommenended (by my boyfriend who had a laminectomy last year on L4/L5 and L5/S1- we are such a couple!)

If you have any thoughts, I would love to hear from you. I am really discouraged and down in the dumps. Thanks!!!!
Herniation at T7/8
Bulge at L4/L5
Protrusion L5/S1
Currently walking with a cane and looking for help!

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Old 11-19-2002, 04:45 PM   #2
Join Date: Nov 2002
Location: Palmyra, VA 22963
Posts: 53
carrington7 HB User

Hello Calip!

I just wanted to say that it seems as though you are not alone. I am a 27 year old female who has beend ealign with back pain now for 1 1/2 years and only last week did they finally do a discogram and diagnosed a tear at L5/S1. It was incredibly relieving however now the ortho surgeon is recommending IDET and I just called my insurance and sure enough it is NOT covered either.

I just almost want to get the discectomy/fusion so that this will be over with and I won't have to pay as much $. I knwo that the IDET doesn't always work either. Have you had any luck appleaing to your insurance company? Is this something that the doctor does for you or do you do it yourself?? Just wondering if you had any luck and what you deided to do.

If you haven't already been magically cured (which I hope you have!!) IN MY opinion, I think you should see a neurosurgeon. at least to get his point of view. I am dealing with both a ortho surgeon and neurosurgeon and they have very different points of view. I have read- depending on insurance companies- that the appeals don't work very it doesnt make it very easy for us. Talk to the neurosurg though and discuss it. It's always good to get another opinion anyways. Maybe a discectomy would be a surer thing?

[This message has been edited by carrington7 (edited 11-20-2002).]

Old 11-19-2002, 06:35 PM   #3
Join Date: Nov 2002
Location: Southern IL, USA
Posts: 56
luvbunny HB User

hey neighbor I'm new to the board too. I am 27 and have a central herniation and annular tear on L5 S1. My ortho wants to do surgery by putting a Lt cage and screws in. I have been told that I am not going to benifit from IDET. Maybe your insurance company is looking at it long term. Maybe they only want to cover something that has more long term benifits??? Who knows Im blowing smoke out my rear cause I dont really know all the pros and cons of these surgeries.... oh well now that I have probably not helped but did manage to rattle on and on [img][/img] I will shut up!

Old 11-19-2002, 10:00 PM   #4
Join Date: Nov 2002
Location: Palmyra, VA 22963
Posts: 53
carrington7 HB User

hello luvbunny (very cute) makes me smile just writing it......

Thanks for the post- just wondering, if you don't mind, why did your surgeon tell you that you would NOT benefit from IDET?? Are you planning on the cage procedure?

I DO appreciate any advice/ideas/suggestions...thanks so much. I'm sick of having these thoughts and conversations in "my mind". at least I can write them out now and ask some questions!

Old 11-20-2002, 11:52 AM   #5
Senior Veteran
Join Date: Oct 2002
Location: San Francisco Bay Area, CA, USA
Posts: 548
Telzey HB User

Hi calip and welcome to the boards!
I also have a L5/S1 annular tear (although my doctor has never graded it, to my knowledge). He says I am a perfect candidate for IDET. Luckily my insurance company will pay for the procedure (although only 65% of what they say it should cost). But it will still cost me about $1000, maybe more. However, I really want to go for the IDET, because it is so much less invasive than a diskectomy or fusion. They don't need to cut you open so there is less scar tissue formation.

You might ask if your surgeon will give you a break on the professional fee. Often the insurance company will pay for the hospital charges, but not the professional fee. Of course you'd have to check with them to find out. My doc's professional fee for a 1-level IDET is just under $2000, and I think the ancillary hospital charges won't be more than that.

Keep trying with the appeals, as well, I think I remember hearing someone saying that a BC/BS rep said they would agree to the IDET if the Saal brothers (who invented the procedure) agreed it was a good case.

Also, I had 2 ESI's (epidural steroid injections) and they both took about a week to take effect, so wait a few days and maybe you'll get some relief!

Best of luck, and keep us posted on your situation!
[img][/img] Telzey
4 years of back pain, but was still able to work and maintain moderate activity (hiking, low-impact aerobic exercise)
Annular tear L5-S1 diagnosed 5/02 via MRI
IDET 12/2/02
1/26/03 Posterior disc prolapse occurs after sitting too long after walking. Causes new pain down left leg.
3/1/03 Leg pain reduced with exercises from the book "Treat Your Own Back" by Robin McKenzie.
3/9/03 Severe, new buttock and thigh pain and numbness starts.
3/25/03 Used McKenzie techniques to treat buttock and thigh pain -- pain reduced
4/4/03 Started physical therapy
5/8/03 Still worse than pre-IDET, but showing slow improvement with PT, McKenzie exercises, yoga, and Hanna Somatics exercises
5/30/03 PT suggests buttock and thigh pain may be from facet joint
7/6/03 Still worse than pre-IDET due to leg and thigh pain and numbness, and have become so inactive I can't tell whether back pain is better. Can't stand for any length of time, can't walk long, run at all, or do any aerobic activity. I regret agreeing to the IDET and wish I had had more patience with the natural healing process of my disc!

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