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First Time, Long Time -- ADR in waiting

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Old 01-17-2005, 09:22 PM   #1
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Join Date: Dec 2004
Location: NJ
Posts: 18
Caz72 HB User
First Time, Long Time -- ADR in waiting

I hate that phrase when people call into radio talk shows. BUT.... it fits. I have read this board for over a year and gotten to know many of you through your back problems, but until today I haven't posted. I am more reserved than your average person but I'll try to stay in touch as much as possible. I know hearing your stories helps me, so I will share mine, and hopefully can shed some light on the new ADR surgery processes since I am currently going through it.

Here's my deal:

I am 32/M/NJ. I have been having back problems since I injured myself in Dec. of 2001. I have a herniation at L4/5 and a very slight herniation at L3/4 that was never addressed because it doesn't appear to be causing me any grief (thank goodness). I've had numerous MRI's, a CT scan, did my 3 epidurals long ago, PT, rest, etc... Ultimately I had 2 laminectomies at L4/5. After the first one, I was doing great for about 18 months (avid basketball player), then I had a recurrence. We talked about fusion, but I opted to go for another Lami, since the first one worked so well up until the recurrence. This one only lasted for a few months and I now have another herniation at the same level L4/5. My doctor thinks I am an ideal candidate for the Charite disc, and so do I from what I have read about it.

So, we are now pushing ahead towards the ADR that I am eagerly awaiting. I will be undergoing a discogram on L3/4, L4/5, L5/S1 in the next week or so to make sure that it's just L4/5 thats causing me pain. Since the FDA only approved the 1-level ADR, if there are 2 discs causing me pain, then we have to pursue another solution (most likely fusion). My doctor is anticipating that I am only having problems with 1 disc level, and therefore will only need a 1 level disc replacement, but the discogram with tell us for certain. If and when we get those results and [i]assuming[/i] the insurance company approves the procedure, then we will set a surgery date. The doctor is anticipating that the insurance company is going to give us a hard time though, because it's workers comp and since the FDA approval for this surgery just came in October, they dont have codes for this procedure yet, and still consider it experimental. So, he has to write letters to them specific to my case, with reasons why I am a perfect candidate for the ADR and convince them that they should pay for it. Apparently they take the ADR on a case by case basis (Liberty Mutual), but not sure if all insurance companies are the same. So that is the latest in my saga. I should know more in four weeks.

p.s. This is the first time my surgeon has done this surgery live. He was recently trained and certified but hasn't done one solo yet. It sounds scary for that reason, but he is a renowned surgeon and has done the fusion surgery thousands of times and this is basically the same surgery except he is inserting the artificial disc instead of bone to fuse the vertibra together. Also I like him and trust him a lot.

Just thought I'd share. I'll keep you posted if you want.

Thanks again. Well wishes to all. Stay healthy!


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Old 01-17-2005, 09:59 PM   #2
Join Date: Dec 2004
Posts: 90
stidw HB User
Re: First Time, Long Time -- ADR in waiting

hey caz, thanks for jumping in and letting us know you story, i just want to let you know we are here and please keep updated. I hope and pray that the adr works for you.

Old 01-17-2005, 10:48 PM   #3
Senior Member
Join Date: Jul 2004
Posts: 221
memawhurts HB User
Re: First Time, Long Time -- ADR in waiting

I just wanted to welcome you to the boards. I hope you are able to get the approval from the insurance company. Please do keep us updated.
Best wishes,

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