Cervical disk replacement surgery: What helps with the pain?

Posted by grandmaR @grandmar, Jun 4, 2022

Hi All!
About 4 years ago, I have disk replacement surgery.
C5/6 was replaced and the recovery was very easy (certainly easier than L3/4 X-Lift Fusion).
I've been having pain issues over the last year (or so).
MRI has shown that other disks are not in great shape, I have arthritis and bone spurs.
To top it off, I am growing bones that are fusing by the replacements, something it shouldn't be doing.
Sadly, the 'representative' from the insurance company is NOT approving surgery to remove the artificial disks.
Only 1% of the people who have this surgery has issues, and I am one of them.
Anyway, just wondering if there is another 1% patient who has gone through the same thing.
Right now, I take injections and I'm in PT (something the insurance company insisted upon).
If anything, it hurts more, but what do I know??? lol
Here's to a pain-free weekend, all!
Ronnie
GRANDMAr

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@grandmar I am sorry you are going through more troubles. Bone growth around an artificial disc is a known risk factor of these implants. I have read literature about that. Bone growth happens because of uneven pressure. It is your body trying to stabilize it by growing bone around it. Have you tried to appeal to the insurance company about their denial? They may be putting you into a bad situation if this is left untreated. The bone growth will continue and may get to a point where the spine is fused solidly around the implant and it may not be operable at that point. That is my guess, and the real answer must come from a spine surgeon.

Your state also has an Insurance Board that is the governing body for insurance companies and you can make a complaint there. The exception to that is when the insurance is provided by an employer and is self funded meaning the employer is paying the bills. Usually these are managed by an insurance company, but because they are employers, that is regulated by the Board of Labor in the state. If this is a Medicare situation, there is also an appeals process for Medicare.

Have you talked to your medical team about appealing the case? They may have dealt with this all before. Have you asked to speak to a supervisor at your insurance company about how to officially make an appeal? Insurance companies have been known to reverse a decision when challenged. It doesn't matter that this only happens to 1% of patients with artificial discs. I am a spine surgery patient (cervical fusion at C5/C6), but I also broke my ankle, and the metal plates on my ankle were causing problems. I had those surgically removed after my bones had healed and the insurance company paid for that surgery no questions asked. You need to make some noise about it with those who are holding decision power over you. What does your surgeon recommend should be done in your case?

REPLY

I have a friend who needed a complicated hip surgery that her insurance refused to cover at first. She appealled the decision and won and had the surgery. I would suggest that you get a complete copy of your medical record, including CDs of and X-rays, MRIs and/or CT scans. Take the records to a different doctor for another opinion about what can be done. If both doctors think you need surgical intervention, file an appeal. The insurance companies usually have a chain-of-command structure for approving claims. The lowest level person's job, in a sense, is to approve the easy stuff and discourage anything he can't find on the approved list. In a sense, the rule of thumb for us is to "get the first 'no' out of the way and move onto the people who have the authority to say yes." It's a process based on hoping people give up easily. So don't give up as a surprisingly high majority of appeals are decided in favor of the insured party. 😏

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@jenniferhunter

@grandmar I am sorry you are going through more troubles. Bone growth around an artificial disc is a known risk factor of these implants. I have read literature about that. Bone growth happens because of uneven pressure. It is your body trying to stabilize it by growing bone around it. Have you tried to appeal to the insurance company about their denial? They may be putting you into a bad situation if this is left untreated. The bone growth will continue and may get to a point where the spine is fused solidly around the implant and it may not be operable at that point. That is my guess, and the real answer must come from a spine surgeon.

Your state also has an Insurance Board that is the governing body for insurance companies and you can make a complaint there. The exception to that is when the insurance is provided by an employer and is self funded meaning the employer is paying the bills. Usually these are managed by an insurance company, but because they are employers, that is regulated by the Board of Labor in the state. If this is a Medicare situation, there is also an appeals process for Medicare.

Have you talked to your medical team about appealing the case? They may have dealt with this all before. Have you asked to speak to a supervisor at your insurance company about how to officially make an appeal? Insurance companies have been known to reverse a decision when challenged. It doesn't matter that this only happens to 1% of patients with artificial discs. I am a spine surgery patient (cervical fusion at C5/C6), but I also broke my ankle, and the metal plates on my ankle were causing problems. I had those surgically removed after my bones had healed and the insurance company paid for that surgery no questions asked. You need to make some noise about it with those who are holding decision power over you. What does your surgeon recommend should be done in your case?

Jump to this post

Hello!
Nice to hear from you!
Sorry about your ankle!
Yes, we have appealed a couple of times.
They say my MRI doesn't look so bad and apparently they don't know anything about the bone-growth and it's possible complications.
They say I need to complete PT before they will consider it.
I tried it once and I had to give up because I was in more pain than when I started. They told me they were doing the least amount they could, already.
But, I'm trying again in a new place.
I really have no expectations, I'm just doing what they say in order to be able to try for the surgery, again.
I am half-way through and it is a waste of time, but I'll do as they say.
I know my surgeon is very upset.
He was going to do a face-to-face, one-on-one appeal, but the insurance company said they did not have a neurosurgeon for the discussion.
So, my surgeon refused to waste his time.
I really don't blame him.
I have 3 more sessions to go with PT, then we'll see what the insurance says this time.
In the scheme of things, my insurance company is not as bad as some.
I've only had one other incident with them.
When it was suspected that I had lung cancer, they insurance company rejected a pet scan, they wanted the doctor to do a biopsy.
Imagine that, they would rather pay for the use of an operating room, an anesthesiologist and have something intrusive done.
The doctor did fight with the insurance company and did get the PET scan approved.
Oh well, and so it goes......
Best wishes!
Ronnie

REPLY
@grandmar

Hello!
Nice to hear from you!
Sorry about your ankle!
Yes, we have appealed a couple of times.
They say my MRI doesn't look so bad and apparently they don't know anything about the bone-growth and it's possible complications.
They say I need to complete PT before they will consider it.
I tried it once and I had to give up because I was in more pain than when I started. They told me they were doing the least amount they could, already.
But, I'm trying again in a new place.
I really have no expectations, I'm just doing what they say in order to be able to try for the surgery, again.
I am half-way through and it is a waste of time, but I'll do as they say.
I know my surgeon is very upset.
He was going to do a face-to-face, one-on-one appeal, but the insurance company said they did not have a neurosurgeon for the discussion.
So, my surgeon refused to waste his time.
I really don't blame him.
I have 3 more sessions to go with PT, then we'll see what the insurance says this time.
In the scheme of things, my insurance company is not as bad as some.
I've only had one other incident with them.
When it was suspected that I had lung cancer, they insurance company rejected a pet scan, they wanted the doctor to do a biopsy.
Imagine that, they would rather pay for the use of an operating room, an anesthesiologist and have something intrusive done.
The doctor did fight with the insurance company and did get the PET scan approved.
Oh well, and so it goes......
Best wishes!
Ronnie

Jump to this post

Hi there,

Saw a few of your posts regarding your disc replacements and decided to join so I could chat with you! First of all I hope you are well and have completed your PT appointments. Have you sorted out your insurance company? I understand the ridiculous runaround they have you go through and do PT before anything else.
I had 2 level disc replacement in June 2021. Everything has been going well and then a about 2 months ago I started to feel one of the discs click. More like a notching feeling. No pain, no other issues other than horrible headaches when I wake up which usually progress to a migraine. In the last 2 months Ive taken more migraine medicine than I had In the prior 2 years. It been hard to find anyone who has experienced noise from their discs - so far an MRI and X-ray shows that the discs are where they’re supposed to be. Today I had a CT scan which will show my surgeon if there is anything wrong with the disc itself. I’ve had migraines and beaches upon waking prior to surgery but these “new” headaches started at the same time I felt the disc “clicking” 13 months post op. Just wondered if you have experienced similar things and what they determined your headaches were from?

Hopefully you are feeling better or have an answer as to your disc situation and future surgery.

-Sherri

REPLY
@sheredwrds

Hi there,

Saw a few of your posts regarding your disc replacements and decided to join so I could chat with you! First of all I hope you are well and have completed your PT appointments. Have you sorted out your insurance company? I understand the ridiculous runaround they have you go through and do PT before anything else.
I had 2 level disc replacement in June 2021. Everything has been going well and then a about 2 months ago I started to feel one of the discs click. More like a notching feeling. No pain, no other issues other than horrible headaches when I wake up which usually progress to a migraine. In the last 2 months Ive taken more migraine medicine than I had In the prior 2 years. It been hard to find anyone who has experienced noise from their discs - so far an MRI and X-ray shows that the discs are where they’re supposed to be. Today I had a CT scan which will show my surgeon if there is anything wrong with the disc itself. I’ve had migraines and beaches upon waking prior to surgery but these “new” headaches started at the same time I felt the disc “clicking” 13 months post op. Just wondered if you have experienced similar things and what they determined your headaches were from?

Hopefully you are feeling better or have an answer as to your disc situation and future surgery.

-Sherri

Jump to this post

Hi Sherri
Welcome to the group and nice to meet you!
I didn't finish my PT. I only got half the sessions done. My husband got sick and I couldn't leave him. Then, 7 weeks ago, he passed away.
I did very well with the disc replacement I had for about 2 years. Then. I started getting headaches, but only when I slept. Guess it has something to do with the position because when I got up, it would be gone within an hour or so.
However, I now get HORRIBLE pain from my shoulder blade to my fingers. I also get the clicking in my neck.
My last MRI showed that I started growing new bone around the surgical site and they are fusing. This is NOT what should happen!!!
I need another surgery to remove the artificial disc's. My insurance company said no surgery. They said my spine looks good and PT should be done.
Don't get me wr, I am blessed to have a great insurance plan, but they hire these 3rd party people to determine authorizations and they are idiots!! Each time they say to get PT, I leave in worse shape than when I started.
Anyway now the paingets so bad, that I actually went to the ER.
I am currently waiting again, to try to get approval for surgery.
We'll see.
How are things going for you now???

REPLY
@sheredwrds

Hi there,

Saw a few of your posts regarding your disc replacements and decided to join so I could chat with you! First of all I hope you are well and have completed your PT appointments. Have you sorted out your insurance company? I understand the ridiculous runaround they have you go through and do PT before anything else.
I had 2 level disc replacement in June 2021. Everything has been going well and then a about 2 months ago I started to feel one of the discs click. More like a notching feeling. No pain, no other issues other than horrible headaches when I wake up which usually progress to a migraine. In the last 2 months Ive taken more migraine medicine than I had In the prior 2 years. It been hard to find anyone who has experienced noise from their discs - so far an MRI and X-ray shows that the discs are where they’re supposed to be. Today I had a CT scan which will show my surgeon if there is anything wrong with the disc itself. I’ve had migraines and beaches upon waking prior to surgery but these “new” headaches started at the same time I felt the disc “clicking” 13 months post op. Just wondered if you have experienced similar things and what they determined your headaches were from?

Hopefully you are feeling better or have an answer as to your disc situation and future surgery.

-Sherri

Jump to this post

I sherri,

My fusion of c5-c7 makes the same sounds and causes the same feeling you described. This was performed in 2014 and almost immediately post PT this showed up. I recently began seeing a acupuncture / herbalist and she has eliminated the pain completely. You may want to speak with some friends to see if any have a relationship with acupuncture / herbalist.

Warmest regards, Ted

REPLY
@sheredwrds

Hi there,

Saw a few of your posts regarding your disc replacements and decided to join so I could chat with you! First of all I hope you are well and have completed your PT appointments. Have you sorted out your insurance company? I understand the ridiculous runaround they have you go through and do PT before anything else.
I had 2 level disc replacement in June 2021. Everything has been going well and then a about 2 months ago I started to feel one of the discs click. More like a notching feeling. No pain, no other issues other than horrible headaches when I wake up which usually progress to a migraine. In the last 2 months Ive taken more migraine medicine than I had In the prior 2 years. It been hard to find anyone who has experienced noise from their discs - so far an MRI and X-ray shows that the discs are where they’re supposed to be. Today I had a CT scan which will show my surgeon if there is anything wrong with the disc itself. I’ve had migraines and beaches upon waking prior to surgery but these “new” headaches started at the same time I felt the disc “clicking” 13 months post op. Just wondered if you have experienced similar things and what they determined your headaches were from?

Hopefully you are feeling better or have an answer as to your disc situation and future surgery.

-Sherri

Jump to this post

@sheredwrds I am also a cervical spine surgery patient, but mine was a fusion. The facet joints can also click and can be affected by arthritis when they get too much pressure on them. These are the joints that allow the spine to rotate. Are you able to reproduce the click with movement or is it random. Has your doctor herd the click?

The migraines you are experiencing may be related to muscle spasms in your neck. If some vertebrae are getting independently rotated by a spasm, it stretches muscles that complain, and it causes muscular headaches similar to migraines. You may wish to consult a physical therapist who can figure out if this is happening. My PT also does myofascial release which has been very beneficial for fixing this problem for me. Here is our discussion on MFR and you can find a provider search at http://mfrtherapists.com/

-Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you heard of myofascial release before?

REPLY
@grandmar

Hi Sherri
Welcome to the group and nice to meet you!
I didn't finish my PT. I only got half the sessions done. My husband got sick and I couldn't leave him. Then, 7 weeks ago, he passed away.
I did very well with the disc replacement I had for about 2 years. Then. I started getting headaches, but only when I slept. Guess it has something to do with the position because when I got up, it would be gone within an hour or so.
However, I now get HORRIBLE pain from my shoulder blade to my fingers. I also get the clicking in my neck.
My last MRI showed that I started growing new bone around the surgical site and they are fusing. This is NOT what should happen!!!
I need another surgery to remove the artificial disc's. My insurance company said no surgery. They said my spine looks good and PT should be done.
Don't get me wr, I am blessed to have a great insurance plan, but they hire these 3rd party people to determine authorizations and they are idiots!! Each time they say to get PT, I leave in worse shape than when I started.
Anyway now the paingets so bad, that I actually went to the ER.
I am currently waiting again, to try to get approval for surgery.
We'll see.
How are things going for you now???

Jump to this post

Thanks so much for responding and please let me say that I’m so sorry to hear that you lost your husband. I hope you have a support system to help?

Well, so far I’ve gone a few days without a headache. I’ve read the results from my latest MRI and CT scan and there does not seem to be any issue with the discs. My neck is full of foraminal stenosis and severe arthrosis and some bulging of my C4 disc which I’m sure will need to be dealt with down the road. As for now I’m not experiencing any radiculopathy or extreme issues as I did before my 2 level disc replacement. I’ll speak with my surgeon tomorrow and get his take on my CT scan results and see if he sees anything weird with the disc that would be causing the notching I feel when turning my head. He also has suggested a neurologist to help with these headaches. When I see the condition of my neck the headaches could be coming from so many things, it was just weird that they started at the same time I started to feel the notching (clicking). My lumbar L4-5 is another issue and can be resolved with a disc clean up surgery. That area has caused numb toes, pain on the top of my feet and pain in what feels like every little bone in my feet. Occasional numbness down my leg.

This has all been a shock to me as I’m not someone who suffered for years with a bad back. I figured my neck was some arthritis coming on earlier than normal. Holy cow was I surprised when my MRI of cervical and lumbar came back in 2021. 😵‍💫

I hope you get an answer soon from your insurance co. Would injections help you at this point?

REPLY
@tedjones77494

I sherri,

My fusion of c5-c7 makes the same sounds and causes the same feeling you described. This was performed in 2014 and almost immediately post PT this showed up. I recently began seeing a acupuncture / herbalist and she has eliminated the pain completely. You may want to speak with some friends to see if any have a relationship with acupuncture / herbalist.

Warmest regards, Ted

Jump to this post

Thanks Ted.

So a fusion makes clicking and notching sensations as well? I guess any movement with hardware in there is a possibility.

I do love acupuncture, but have not done it for this issue since it’s relatively a new “side effect” taking place. My discs aren’t causing pain, but the arthritis and other areas of stenosis are. I’m hoping to find a good neck masseuse and now I’ll look for an acupuncturist. Thanks for the recommendation!

🙂

REPLY
@jenniferhunter

@sheredwrds I am also a cervical spine surgery patient, but mine was a fusion. The facet joints can also click and can be affected by arthritis when they get too much pressure on them. These are the joints that allow the spine to rotate. Are you able to reproduce the click with movement or is it random. Has your doctor herd the click?

The migraines you are experiencing may be related to muscle spasms in your neck. If some vertebrae are getting independently rotated by a spasm, it stretches muscles that complain, and it causes muscular headaches similar to migraines. You may wish to consult a physical therapist who can figure out if this is happening. My PT also does myofascial release which has been very beneficial for fixing this problem for me. Here is our discussion on MFR and you can find a provider search at http://mfrtherapists.com/

-Myofascial Release Therapy (MFR) for treating compression and pain: https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Have you heard of myofascial release before?

Jump to this post

Hi Jennifer,

Thanks so much for the information. And you know, I do have so much arthritis on the facet joints that they almost look like they are incased in concrete. I’ll add a photo. The discs seem to be in fine condition according to my scans, but with all that is going on in my neck I’m sure spasms are a real possibility.

I realized if I put my hand on top of my head and sort of rock my head from side to side I can produce the notching feeling. My husband had to get really close to my neck in order to hear it, my surgeon has not heard it yet. Otherwise it happens randomly. I will check out the links you provided (thanks so much) as it sounds like the MFR could really be beneficial and right now any massage or manipulation (not chiropractic) sounds good.

REPLY
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