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@nd opinion says ...

nurselynnaiennurselynnaie Posts: 167
edited 06/11/2012 - 8:57 AM in Chronic Pain
So went for my second opinion today to a doctors office in a different City about a hour away. He tells me the neurosurgeon I am seeing is crazy , that a bone growth stimulator will do nothing for my loose screws. The only way to "hopefully" fix it is a revision. However he would not be able to claim it as comp because it results from a failed fusion. I said well working has caused the screws to loosen correct and he said yes, but it would of happened eventually because no fusion has occurred.
He said I would probably get 50% comp instead of 100, and my insurance would have to pay for the fusion. I don't care what insurance pays for it, I do care about dropping my comp.... that would suck so I say well comp bought me the bone growth stimulator, so they are taking responsibility for the screws loosening, he said I will not commit Comp fraud lol ... I said oh no no I was just asking why they would of paid for it if they didn't have to...
Anyway here is the issues, I have already had two surgeries and this will be the third in the same spot same scar, they will have to carefully pull back the scar tissue and peel it off until they get to the hardware, the doctor says there is a chance that peeling off the scar tissue could tear the dura sac and cause paralysis. I asked what percentage and he said he didnt want to put a number there but that it was higher percentage then with my first two surgeries.
Ya well, kinda made me nervous, and then he said if it didn't work this time I would be out of luck because no one would ever be able to perform another surgery in that area again.Honestly what do I do??????
Take the chance?? Or just give up and live as good as a life as I can with how I am.
It was a very disturbing appointment this doctor showed me that the screw that caused the second surgery did not pop out into the spinal canal that's where the idiot first doctor put it, he also showed me where the first surgeon started to put a screw but then changed his mind so there is just a hole there in my vertebra, Also he says and I quote " what the hell is that, oh my god is that your cage in your canal? that's permanent nerve damage" I am like what I don't know and permanent what if you don't take it out and fix it or already . He said both whatever that meant.
Even more confused now then I was before. Any help is appreciated... gonna take a Ativan now, since I finally got them ...
Sorry this is so long I just really am at a loss.


  • Why can't you haveALIF with percutaneous screws, rods etc.I had traditional open surgery for l4-S1 25 years ago and just had ALIF and was then flipped over for rods and screws and bolts and anchors and all the incisions are in diff locations than first surgery and the recovery has been easier than the previous. Just an idea, keep asking doctors and don't give up until you find the one that gives you better odds and is tops in his field even if it means flying across the country. Your life is worth it!!!!
  • Sheryl,

    Sorry that you didn't get the best news... Maybe you should consider getting a couple more opinions?

    Rascal has a point. It is obvious that this NS doesn't do the ALIF approach. Mine doesn't do these either. It would we worth your while to get further opinions.

    Have you retained an attorney for the WC? He may be able to get them to pay, or work with WC and your personal insurance to come up with an equitable division.

    Try to stay positive :).

  • I agree...I think you need more opinions...at LEAST 1 or 2 more. I went back to my NS 2 weeks ago and he is recommending a repeat MRI, possibly another CT myelo, and surgery on T10-11. However, there is some question as to whether that is actually the level that is causing the trouble, so I decided to get 2 more opinions. A co-worker, last week, gave me a recommendation for a NS affiliated with the hospital I work at, so I went to see him today as well. I am going for my next one in 2 weeks, and if I am still undecided after that one, I have another one scheduled for 12/1.

    I am sorry you are in this dilemma. I can totally relate, though. My mind was absolutely running after my appt today, even though both surgeons are recommending the same surgery.
  • My cousin gave me a name of another surgeon yesterday and then my other cousin who is a RN in a ICU said she knows a terrific doctor who will be straight to the point and let you know whats up. So I am calling them today,
    I am going to keep going until I find someone that makes me comfortable.
    anyone know why some back surgeries are done with a neurosurgeon and some with a orthopedic? Just curious because so far up til yesterday I have only dealt with neurosurgeons and yesterday the doctor was a orthopedic surgeon.
    Best of luck to everyone to have a less painful day then yesterday :) lol
  • Sheryl that is great news. More is better inn this case.

    Here is a good explanation about the 2 different doctors.

    Both neurosurgeons and orthopedic surgeons must complete medical school. After medical school, doctors may choose specialized training.

    Neurosurgeons complete six to seven years in a residency program studying spinal and brain disorders and surgical and other treatments of the spine and brain. Their board certification is through the American Board of Neurological Surgery.

    Orthopedic surgeons complete a residency in four to five years that includes surgery on the spine. They may concentrate on spinal surgery, sports medicine, trauma or other areas during their residencies. The American Board of Orthopedic Surgery certifies orthopedic surgeons.


  • That makes me understand better ...:)
  • It's interesting that we are sort of left in a similar place. My first fusion was at L4/5 for a variety of spinal problems, and right after surgery, I developed post op onset Cauda Equina Syndrome. After 18 months of continuing downhill progress, I saw a neurosurgeon , who did another MRI and CT scan, which showed two of the original screws loosening and backing out of the vertebre, and of course, no fusion. I had a revision , added bmp, and redo of the fusion 18 months out. Interestingly enough, I am now facing my third surgery- a second onset of Cauda Equina syndrome at a higher level than the first- a spinal canal diameter of 3.5 mm at it's widest at L3, L4, and L5. The dura is adhered to the vertebre at those levels and the only difference is that I am told that I will become totally paralyzed if I don't have surgery. My canal is so narrowed that it barely appears on the MRI's and CT scan. The last two surgeons that I saw at a major NYC hospital told me that I must have surgery, and that all it will take is one wrong move, and I will be in the wheelchair that I have tried so hard to avoid having to use full time.
    I'm sorry that we both are facing similar problems, and having to make similar decisions. I hope that you will visit the nearest major teaching hospital for a second, third and fourth opinion. And that you will find someone that you are truly comfortable with.
    Someone asked why they can't go through the front for your revision and I think that the reason is the screws and cage in the back and their location. In order to remove and replace those screws, they need access from the back, and to safely remove the cage from the canal if it is there, needs to be done from the back. There isn't enough room to access the canal and screws from the front, plus at the L3-4, L4 levels, there are major arteries that run directly infront of the vertebre, which if injured or cut during surgery can result in the loss of life or serious brain damage.
  • The first two neurosurgeons where from The University of Rochester which is a huge teaching hospital. That is suppose to be a well known wonderful hospital, but then again the doctor in Pa that did my initial surgery and the second one is one of the best surgeons in his area to.
    Can I ask you ? The dura being adhered to the Vertebra, what will they do to fix that? When I saw the orthopedic surgeon the other day, he was more focused on my dura being torn when they try to peel off the scar tissue, if they go to deep in peeling the scar tissue it will rip the dura and paralyses me. ( that is what the doctor said)
    We sound almost like twins huh, I am so sorry you are going through this, because I know the anxiety, stress and fear that come along with this crazy part of our lives
    I have made some calls and even though the first surgeon screwed up and it is apparent in the Myleogram and MRI, I am outside the statue of limitations. lol I said ummm, he was my doctor he said everything was fine, I was released back to full time work, why in the world would I ask him the professional to double check his work when he said it was fine of course I am past the statue of limitations.
    I am so frustrated now, especially thinking I may lose my comp while I have to go through the surgery. Which I pretty much have to have once I find a doctor I am comfortable with, because the only other option would be to wait until something broke in my back and have to have it anyway and it might be too late by then if it breaks the right way I won't be walking anymore.
    Oh... This is something I forgot to tell everyone I think...So I always have this burning on my outer left hip thigh are to the point where I am rubbing it and whining .. Doctor the other day says well that's just bursitis from your limping a shot will fix that lol .... five doctors later and finally maybe I can get rid of the portion of the pain.
    I wanna poke my own eyes out I swear lol .:) Gotta laugh at it all or I would go freaking crazy
    Have a pain free day everyone and thanks so much Sandi for sharing and supporting I need it
  • I agree with getting a couple more opinions.
    Also since you said this is w/c, and its a failed fusion, w/c should cover it.
    If you havent talked to a lawyer yet, now would be a good time.

    My best to ya.
  • Thanks , They are saying that the original injury from me doing laundry caused me to have initial fusion, so it wasn't comp. The injury in May of this year aggravated the failed fusion, but the fusion caused the pain for something ... So they are saying the revision wouldn't be covered by comp, since it failed and would of had to be redone at some point in time anyway , if I wasn't working my tail off it probably would of been a few more years before anyone found out the fusion failed.

    I think that's what they are thinking but I am at a loss here. Went to my PM doc today and told him the doctor who gave me a second opinion about the surgery thinks I have bursitis in my left hip, and I said could you give me an injection, he said stand up..... hmm your too young for bursitis , I don't agree with that diagnosis.

    If I wasn't in pain and want this over with I would go to as many doctors as I could just to see how different their opinions are I find it amazing, That they differ so much ..
    Have a great Evening guys

    PS Back to the original surgeon on Monday to let him know what the second opinion said..outta be interesting.
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