“To exclude patients from fusion will save money; rationing spinal care will cripple the back bone of America.”
On July 12, 1982 at 10am I fell approximately 35 feet at work from scaffolding and literally broke my back. I recovered from the fractures but suffered from an insidious onset of low back degenerative disc disease. This problem was underscored in 1997 as I required an L5/S1 diskectomy for left leg radiculopathy. My leg pain was greatly improved but my back pain worsened. By 2005 I was wearing a TENS unit ramped up to the maximum and requiring cortico-steroids and anti-inflammatory treatments to have anything akin to a normal life. Crippled and hunched over by the pain, claudicating at 50 feet my patient, a nurse, who was scheduled for surgery cancelled until I got better so that I could perform her spinal surgery.
I had a discographic workup by Dr. Charles April and then had a combined intertransverse facet fusion with PLIF interbody by Dr. John Logan and Dr. Donald Dietze; orthopedic and neurosurgeon respectively.
Since the fusion I no longer require meds for my previous spinal maladies. I no longer am imprisoned in a back brace for support. I have a healthier professional, social, and family life. With a new back I was able to hunt for red stag in the Andes, and return to Asia to adopt my fourth child; and yes, repair the nurse I mentioned earlier. As the official spokesperson for Spine Health Foundation I have helped spearhead a project that provides spine care, yes fusion at times, to those uninsured or under insured.
A British philosopher in the 1900′s said “In the last resort, we must accept as true a proposition of which the negation is inconceivable”. Yes, lumbar fusion works for degenerative disc disease. Aesop said “Every truth has two sides. It is well to look at both sides before we commit ourselves to either side”. To exclude patients from fusion will save money; rationing spinal care will cripple the back bone of America.
Morgan Lorio, MD
ISASS Coding and Rembursement Task Force
AHRQ has requested comments on spinal fusion for painful lumbar degenerative disc or joint diseases.
The deadline for comments is 11:59pm on February 21, 2012. Visit this link to submit your comments:
AHRQ: Comments on Key Questions