Xray showed Spondylolisthesis, but I do not have that report.
MRI: FINDINGS: Visualized osseous elements intact with no evidence of fracture. Marrow signals within normal
limits. Normal lordotic curvature of lumbar spine. Conus medullaris & cauda equina normal.
1. L3-L4: 3 MM CENTRAL DISC HERNIATION WITH COMPRESSION OF THE ANTERIOR THECAL SAC
AND NO SIGNIFICANT LATERALIZATION BEST APPRECIATED ON AXIAL T2 WEIGHTED IMAGE #9/20.
2. L4-LS: EARLY DESICCATION AND LOSS OF NORMAL WATER CONTENT. 5 MM CENTRAL L4-L5
DISC HERNIATION WITH COMPRESSION OF THE ANTERIOR THECAL SAC AND SLIGHT NARROWING
OF BOTH THE RIGHT AND LEFT L4-LSINTERVERTEBRAL FORAMEN. DEGENERATIVE CHANGES
WITH HYPERTROPHY WITHIN THE RIGHT AND LEFT L4-L5 FACET JOINTS.
Had pain shots for lumbar pain in 2008, but did not put together that my back was causing severe leg weakness and pain.
Fired from my job of 15 years because I could not get to work on time, stiffness and pain horrible in the mornings. Gained 50 lbs. in fluid, and went from dr to dr just to have them tell me I was fat! Finally went to a rheumy, who said it could be my back. Checked reflexes and said I can't help you, you need to go to TX Back Institute.
After xray showing spondy, Surgeon sent me for MRI. Said I was a candidate for surgery, and I said yippee, finally no more pain and edema. Sceduled surgery, got cleared by psychologist and medical exam.
But no, Humana Open Access denied my claim for surgery saying it was not medically necessary. This doc was supposed to appeal and he did, but they still denied. Never heard from his office again, so went to a top doc neuro. he said they won't turn me down, I'll do a 180 (first doc was gonna do a 360), but they denied, daying they had already denied a previous claim with the same codes for this patient.
After I already went to 2nd doc, got letter from OrthoNet, who is doing the denials for Humana, that was sent to first doc denying ther initial claim saying again,
"not medically necessary, no CT scan to confirm the pars defect read by the radiologist that is typically done to show a pars defect. The surgery is not indicated without proven isthmic defect and without a failure of conservative treatment including exercises and activity modification.
So the initial doc dropped me after the 2nd doc asked for the xrays, and the 2nd doc's asst. said they will do everything they can to help me, but nothing is happening (I have since provided them with this letter) and it has been 30 days since I was there. Right now I'll do well to get them to refill pain meds, which I am working on now.
My left leg is horribly painful feeling like a hot poker is stabbing the side of my calf, radiating pain from hip to calf, spasms under buttocks, both calves burn and ache. I have had bowel issues for quite some time, so the MRI did not correctly reflect cauda equina.
I can't work, I can't go visit my grandkids, the summer heat is making me sweat incessantly, and I am living a miserable existence.