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Hello All

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:39 AM in New Member Introductions
Nice to find this board. By way of introduction I will give a short synopsis. Started having pain in 2005. Went away for a while then recurred about a year ago. Intense pain in lower back and right leg. Up to now I have had therapy, facet injections, total of 12 other injections, 6 nerve cauterizations, various meds, MRI and Discogram and CT.

Discogram revealed torn disc at L5S1. Appointment to see doctor in Raleigh December 17th. I saw his PA in October, she talked to him and he sent me for the Discogram. The Doc that did the Discogram said the only thing to do is to remove the disc and fuse.

In looking at my insurance, BCBS-NC, it appears they consider everything except a P-LIF or A-Lif as investigational and will not cover it. I sure cannot pay for it myself. So thats where I am at at the moment.


  • Welcome to Spine-Health, home of all things spiney. You'll find some great information on SH and there are wonderful friendly people on the forums that are more than willing to share info and war stories.

    I'm sorry you're having pain and that none of the conservative treatments worked for you. There are a lot of us in the same boat.

    I personally have no experience with BCBS, but I've heard some stories of other members that have had issues with that insurance as well. You might find some good info in the Health Insurance section of the forums.

    So, I assume you won't know what surgery your surgeon is going to suggest until Dec. 17? Is this surgeon a fellowship-trained spine surgeon? I think that if you're going to have a fusion, it might indeed be an ALIF, but I'm not a doctor so don't pay any attention to me. LOL

    Anyway, browse around. There are interesting stories all over the place here. Again, welcome to Spine-Health and I hope you find this site a little sweet spot along your spiney journey.

  • I have BCBS and have never had a problem having the conservative things covered. I am not in NC though so it may be different in other states. Hopefully someone else will come along and offer some advice. Good luck and keep us posted.
  • It's actually even more complicated than that. There are multiple plans called, for example, Blue Cross and Blue Shield of Alabama, depending on what kind of policy the company for which you work negotiated. For example, last year my husband worked for a local university and had BCBS in our state that was a state policy. He changed jobs and is working for a major manufacturer but still has BCBS from our state. Coverage is entirely different, and as my company has BCBS but in another state, my policy is different still, and worse, it's different this year than it was last year or three years ago when I had my fusion. It's basically a crap shoot.

  • Yeah it is a crap shoot. I do not know yet what type of surgery, however due to some facet involvement I suspect that it will be an A-LIF. The BCBS plan that my company has is a very good one, however they do consider all of the newest surgical procedures "investigational." So there are basically three choices, microdisectomy, which I doubt for the above reasons, A-LIF or P-LIF. Been in constant pain for 18 months, getting steadily worse now. Back to the PC Doc yesterday, upped pain meds. Walk with a cane 90% of the time. Had all the conservative stuff. Just hanging around until the 17th.
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