Medicare Coverage Advisory Committee re Spinal Fusion

Posted by Twocoastsm @marlenec, Jan 24, 2023

I just read an article in the LA Times about opioid use for chronic pain and it cited a summary of findings by the Medicare Coverage Advisory Committee regarding spinal fusion surgery for low back pain/degenerative disc disease. The article mentioned the committee’s rather “tepid” appraisal of the effectiveness of this surgery despite the fact that Medicare pays for many procedures per year patients. As a 72-year-old to whom fusion has been presented as a possible/probable surgery to address spondylolisthesis and low back pain, I wondered if anyone in this group was aware of these findings and what your thoughts are?

Interested in more discussions like this? Go to the Spine Health Support Group.

I'm following this closely as I too, have been told that spinal fusion, due to degenerative disc disease (DDD) is my next step. I'm of the opinion that this surgery will not bring the results I'm looking for & will lead to scar tissue on top of DDD & already significant arthritis in my L-S area.

REPLY
@coachdavid

I'm following this closely as I too, have been told that spinal fusion, due to degenerative disc disease (DDD) is my next step. I'm of the opinion that this surgery will not bring the results I'm looking for & will lead to scar tissue on top of DDD & already significant arthritis in my L-S area.

Jump to this post

I started out with arthritis of the spine some years ago, it has progressed to DDD. X-rays and Mri showed spinal stenosis and scoliosis. I was referred to pain management about two years ago. So far I have been through nerve block, radio frequency, si joint injection, bilateral hip bursa injections, none of procedures helped. I had a minuteman lumbar fusion this past Oct. and it was one of the most painful things I have gone through. I feel worse than before the surgery. I am doing PT at present for sacroiliitis but that just makes me sore. I also have bone on bone knee pain which make nights and early mornings the worst. I have opted not to take the opioids because of side effects. I just grin and bear it and stick with Tylenol. I don't know what the next procedure will be, but I keep hoping for the best.

REPLY

You need to look at statistics on the number of people who have had back surgery and who have been helped and who have not. When you’re in pain and a solution is offered and its success rate can be substantiated I’d say go for it, as I did in 1990. But I said no to remove my old metal and put in new titanium as my pain is no longer that intolerable.

REPLY
@jenatsky

You need to look at statistics on the number of people who have had back surgery and who have been helped and who have not. When you’re in pain and a solution is offered and its success rate can be substantiated I’d say go for it, as I did in 1990. But I said no to remove my old metal and put in new titanium as my pain is no longer that intolerable.

Jump to this post

My pain doctor said he had good results with the minuteman procedure, he also said there was no down time, so I agreed to have it done. I have been in misery ever since. I have read that for some people it was helpful and for others, not so much. There are pros and cons about lumbar fusion, even from surgeons. I don't know what will be next, I do know there is no way I will have this hardware removed or another one put in. I was very optimistic before all procedures, hoping this will be the one, only to be disappointed each time.
I'm glad your pain is tolerable; I hope I can reach that point. I would be happy if I could stand for more than five minutes.

REPLY

It’s the chances we take for relief and sometimes we aren’t that lucky. I am sorry you’re not having success with your implant device. Having worked in healthcare my entire life I believe in the least the better. When we are in pain and are offered some glimmer of hope we jump. Since my hardware is pretty old considering I don’t think anyone could get to my L4-L5-S1 area to place wires due to my bars and I’d have to be in a whole lot more discomfort too. I did just read the FDA approved another back pain relief system after successful clinical trials. Sorry I don’t recall the name. Good luck with your journey toward pain relief.

REPLY
@jenatsky

It’s the chances we take for relief and sometimes we aren’t that lucky. I am sorry you’re not having success with your implant device. Having worked in healthcare my entire life I believe in the least the better. When we are in pain and are offered some glimmer of hope we jump. Since my hardware is pretty old considering I don’t think anyone could get to my L4-L5-S1 area to place wires due to my bars and I’d have to be in a whole lot more discomfort too. I did just read the FDA approved another back pain relief system after successful clinical trials. Sorry I don’t recall the name. Good luck with your journey toward pain relief.

Jump to this post

If recall name, please post, as am on the lookout for meds least damaging to my cirrohtic liver. TY

REPLY

It’s another implantable e-stimulation device not drugs.

REPLY
Please sign in or register to post a reply.