Originally Posted by Original post Aug 12, 2003

SURGERY DATE: December 2, 2002

SURGEON: Jack Zigler

SURGERY LOCATION/CLINIC: Texas Back Institute (Plano, TX)

LEVEL(s): L4-L5, L5-S1

COST =
AMOUNT BILLED: unsure
INSURANCE ALLOWED: unsure
OUT OF POCKET: about $500
TRAVEL: next to nil (TBI is less that 40 miles from my home)
EXPLANATIONS? Insurance (Unicare PPO) denied payment for the primary surgeon's fee for performing 2 procedures to prepare the vertebral bodies and insert the artificial disks due to the procedures being experimental. Curiously, they paid the assistant surgeon's fee for those same procedures. A settlement was reached to my favor (no thanks to Unicare).


ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...: over 30 years ago

PRIOR SPINE SURGERIES AND PROCEDURES: 2 laminectomies/diskectomies in 1990/1991

PRE-OP MEDICATIONS: Hydrocodone, Neurontin, Wellbutrin

PRE-OP DIAGNOSTICS:discogram, MRI, CT

PRE-OP NEUROPATHIES: Lower back pain only

PRE-OP CONDITION: I had primarily moderate to severe lower back pain with the L5-S1 joint contributing most of the pain. I was actually able to do quite a lot although I had to be constantly on pain-killers or in pain. My main problems were that I could not participate in any activity for more than a few minutes. That included sitting, standing, walking, lifting, squatting, and so forth. It was especially troubling on the (paying) job. As a writer, I have to sit at a computer workstation for long periods and that was not possible. Coitus? What is that?

TIME POST-OP AT ORIGINAL POST HERE:
8 months

RATE SUCCESS / MEDICATIONS / NEUROPATHIES / DESCRIBE CONDITION 1 YEAR POST-OP: Still doing well except for the feeling of a "presence" in my lower back. Radiologicals at 1-year followup exam revealed anterior heterotopic ossification of the L4-5 prosthesis resulting in that artificial disk being essentially auto-fused. Although this is VERY disappointing, I have good ROM and do not feel that I have any additional morbidity due to it. (I am exploring non-pharmaceutical methods of reversing HO. I have found one method that I believe will work and it's NOT drinking apple cider vinegar!) Currently taking only 200mg BID Celebrex, mainly for arthritic hips and knees. It's helping the lower back too.

RATE SUCCESS / MEDICATIONS / NEUROPATHIES / DESCRIBE CONDITION 18 MONTH POST-OP: The HO has progressed significantly and has not shown any signs of reversal. My pain has returned to its pre-surgical level, but it is a different kind of pain. I have the feeling that there is a mass in my lower back (probably because there is actually a mass of bone in my lower back overgrowing the disk space at L4-5). Pain level is minimally affected by position/activity level.

Although I'm fully functional right now and L5-S1 is intact and working, ROM seems to be decreasing despite daily stretching/exercise. Prognosis looks bad--mostly unrelenting pain. Now on pain management-- 10mg hydrocodone up to QID. [Frown] Looking into accupuncture as an option. Also, I have changed my antidepressant to a single-dose version for better compliance.