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Two Surgeries same operation or separate?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:36 AM in Back Surgery and Neck Surgery
I have been diagnosed with cervical stenosis based on MRI. I have been evaluated by two surgeons both agree treatment choice would be a posterior cervical laminectomy and cervical corpectomy. One doctor would one procedure on the first day and the second procedure on the third day; the other would do both procedures during one operation. My major symptom is loss of feeling in my legs when standing without movement for 10-15 minutes. Sitting down restores feeling in the legs within a few minutes. Driving a car can cause loss of feeling in right leg. No pain, just occasional stiffiness in the neck. Is it more the practice to do two separate surgies or both done at the same time? I would prefer undergoing one surgergy unless there is greater risk between all in one and separate surgeries. Anyone have information about this?. One surgeon recommends immediate surgery to prevent further damage to spinal cord due to fall or whiplash type injury. The other says "wait and watch" is not unreasonible as well. Comments based on your experience?


  • Here is an answer that no one wants to hear but is most likely the truth. Both of those procedures are considered "major", and have fairly significant reimbursement by themselves. However, when two procedures are performed on the same day, the first procedure gets paid at whatever the rate the doctor negotiated with your insurance, but the second procedure is cut by at least 50%, and some insurance companies like Aetna or Cigna will "bundle" - meaning they won't even pay the doctors at all for the second procedure. It's really not fair to the doctors, (moreso the evil ways of the insurance companies); how many of you would agree to work one week at your regular salary, then take a 50% pay cut or not get paid at all every other week? I think it is an area where we need health care reform so the doctors actually get paid for what they do instead of the insurance company CEO's making 200 million a year. When I had to get some injections done my doctor wanted to separate them a week apart for this reason (of course they didn't tell me that), but I was OK with it because I want a happy doctor, not a doctor that sees me as a charity case (I would have felt differently if they were going to put me out with general anesthesia though). This is also why some doctors will break a 360 degree fusion into the front (anterior) one day and the back (posterior) fusion the second day. Spine surgery is a very stressful job - and the malpractice expense alone for most doctors is well over 100K per year. I really feel sorry for the spine doctors, and don't blame them one bit for trying to make money through selling equipment etc. And no, it doesn't do an ounce of good to try to argue with insurance companies on behalf of the doctors. Rather than tell patients the ugly truth about insurance re-imbursement, many will give reasons like "its so much to do at one time" to justify splitting it into two days. There are some limits, to doing too much surgery (one example is a face lift and a tummy tuck with liposuction at the same time LOL). But in honesty, one of your doctors is willing to suck up the price-cut to put your body through less anesthesia, the other one wants to get paid for what he does period.
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