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Targeted Disc Decompression...Advice Please.

jsirabellajjsirabella Posts: 311
I was going to bring up my old thread but so much has changed and I really thought it was over for me but something happened today that may have changed my thinking and I really need advice.

Not to repeat all but quick recap is that by August I was using a cane and terrible spasms and constant sciatica pain. Now after 2 epidurals but more important my own made PT program with the help of docs, this site and gweenie's husband story I can now walk for 4 miles, stand for hour and even started some weight training exercises as prescrived by doctor. My life is really coming back and my doc thinks by January big turn around and probably by March will probably be close to normal.

Anyway a cycling friend said I must go to this hospital in NYC as I am local NYC and he is the only one I would let touch me. I called and the price was $500 for the visit and no insurance accepted. But my friend insisted you have the money and must go. I went today.

First I did not see the TV star doc in the beginning as dealing with one of his understudies and it was the same old tests and the same old response of you are on the right path now so just keep going and we can change your med. I was thinking waste of money.

Than the big cheese comes in and an amazing nice guy. More important he corrects the associate as he is still getting a daily pain average of a 5 so we should do more. He told me after 6 mos of conservative treatment you really need to do more or that pain is probably not going away. He than put up my MRI and drew pictures of two different procedures he recommended, one where they remove some of the nucleus jelly with a needle and the other he called Targeted Disc Decompression. He said we do not need a discogram as while you have very little bulge on L5-S1, it is coming from the L4-L5 based upon epidural and emg test results. He says it is the only procedure he has done where people claim 100% pain gone and so far no one relapsed while one patient of his for nucleus removal did relapse. But he said as long as we get that needle/wire in the right place he says you will get relief in 2-3 mos. He has had patients who after pain for 5 years get relief from it. You really need to fall into the category of disc protrusion to be a candidate and luckily you are. They gave me all this info and told me to google it and look it up and do your research.

Now I am confused...should I continue on my course and hope that the pain level continues to decrease with my current strategy or jump in...I have to admit the guy really seemed to know his stuff.

anyone had this procedure, heard of it ... it seems based upon literature that they basically stick a needle and burn the area for 14-15 minutes where the protrusion is...the recovery while not bad is almost as if you had a surgery and will take a couple months to feel effect.

Thank you all for reading...



  • I just have one question before I write more. Do they accept insurance for the procedure?
  • http://www3.interscience.wiley.com/journal/121417699/abstract?CRETRY=1&SRETRY=0

    Results. Eighty-four percent of treated patients were available for follow-up at 12 months. The mean reduction in leg pain VAS scores was 2.6 points (40.6%, 95% CI 1.0–4.1). The mean reduction in back pain VAS scores was 2.4 points (44.4%, 95% CI 0.8–4.0). SF-36 BP scores improved 28.8 points (95% CI 17.5–40.0) and SF-36 PF scores improved 25.4 points (95% CI 13.0–37.7) on average. Effect sizes were small for VAS scores and moderate for SF-36 scores. Fifty-four percent of disc herniations were improved or resolved on MRI. No device-related or intraoperative complications were observed.

    Conclusions. Targeted disc decompression provided moderate improvement in leg pain and function in the majority of patients with chronic radicular pain.

  • As for the insurance, I honestly do not know but with my plan I am allowed to go out of system and get a certain amount of it covered.

    But if we put aside the dollar issue, do you think it is a good procedure to try given the outcomes?

    Also in my case would you think I should go that route or wait a bit of time before trying such a procedure since I am on a pretty good run right now. The recovery seems very similar to surgery where you are limiting yourself considerably for the first two months. Than you can start to do more slowly.

    He said given my MRI no need to worry about permanent nerve damage. My gut tells me wait till January-March and if things seem to be stuck in one place with no further improvement or going backwards than give it a try...

    Too confused right now...

  • I think that makes sense to wait a bit longer. It sounds like you have been making some progress (rather than going in the other direction.) Some of the articles I pulled up didn't make the procedure look all that great. The placebo group seemed to do as well as the group that had the procedure in one study I looked at.

    On the other hand, I don't think it would do any damage...the worst outcome would be that you are just back where you started from...(I think.)

    The reason I asked about insurance is that if the procedure is considered experimental (ie., there is no proven track record, not enough statistic information), the insurance companies will not cover it. That does not necessarily make it bad...just more of an unknown. With the laser disc surgeries, damage can be done, but in this case, it sounds like at worst, you just wouldn't get the relief you are seeking. The rap on the laser surgery is that the effects are not long-lasting. Patients may be pleased at first, but down the road a bit, all the same problems return.
  • I have a couple of thoughts here, the first being that you're one of the very few lucky ones that is having great success with conservative treatment. Every spiney I know would rather heal via conservative methods that do any kind of surgical procedure.

    My second thought is you mention that your gut is telling you to wait and I believe that a person has to really listen to what their gut is telling them. This guy will still be around in a few months, so that gives you even more reason to listen to your gut.

    Take care js, and keep us posted.
  • I am thinking the same way...as I have had success while never as much as you would like, it is success. I believe a few more months to see where I am at and than try this procedure if I am at a stand still or getting worse. By that time it would be more than 6 mos of pain and 12 mos since the initial injury and weakness.

    Why add in an unknown variable unless you have to. I agree with you gweenie that worse case scenario seems to be waste of time and money. The procedure seems to cost about $6500. I would go into debt for that if I could get relief and cath you are right that he and this company that produces this device looks like they will be around for a while.

    The reason why the doc made me really feel good is that someone finally got me. He explained in no unclear terms that you are one of that group where you are not bad enough to have surgery and not advised but you suffer chronic pain. He explained this procedure is for your group.

    I think I will keep this one in my back pocket for the next few months and pull it out of needed. I really thought I had no options atleast now I feel I do.

    I wonder why the other docs did not know advise about this procedure...I guess that is why we go to so many docs...lol.

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