u/SarcasticScorpio2033

Lumbar fusion just below the curve only

After VBT denial for my 22YO daughter, surgeon proposed Apical fusion. ( which will prob get denied as well). Decided to get second and third opinion. Renowned surgeon at top hospital reviewed her mri and EOS bending X-rays today. Noted her Thorolumbar curve from T11-L4 with sadly some degeneration at L4/L5 and bulging at S1, asked her a ton of questions and proposed the following:

Fusion only at L4/L5 and S1 which he believes will also correct the curve from 45 to 30. To test if all the awful pain she has suddenly started feeling after starting a career and sitting at a desk for 8 hours is coming from those degenerating discs, he suggested an epidural shot in L4/L5. If pain is reduced would prove pain is coming from discs below the scoliosis, not the curve! We would then proceed with the fusion at L4/L5 and S1. Asked him about addressing the curve he thinks maybe when she’s in her 50s she may have to have some instrumentation but for now it should be fine.
I am blown away. Another appt with another top surgeon later this week and hoping he proposes same…

Anyone ever try this approach?

How important is it to have a strong core before this surgery? Non athletic individual but going for PT and massage right now.

Is fusion our only option?

This morning I left my home to go to work without my 22 yr old who is working for my company. She has a 45 degree lumbar curve from T11-L4 with disc degeneration already at L4/L5. I fought my healthcare company, United Healthcare to consider her for VBT due to her clinical status and the fact that she met every criteria of their policy but her age, but each appeal was denied as not medically necessary. Even with our company president writing in and senators flagging the case at the Dept of Finance and tagging UHC on Instagram. Their medical director saying in a peer to peer that if this was his daughter he would totally want VBT but it’s their policy so no. Wouldn’t he push to change to policy to give his kid a chance? Even the NYS external review was denied- reviewed by someone who was not even a spinal doctor. (Absolutely unacceptable).

So now we face fusion as we are left with no choice. I have so much fear about a fusion above degenerating discs. We are at a loss.

She cried in my arms this morning saying “how will I have a life- how will I hold a job- I’m in so much pain”

We are in NY. We will have a call with our surgeon tomorrow and I made an appt with another excellent surgeon at a different hospital as well just to get a second opinion.

Is fusion truly our only option for a 22 year old with great flexibility? Bending X-rays show possible correction from 45 to 17.

Anyone have disc replacement and fusion ?

Feeling I failed her.

This morning I left my home to go to work without my 22 yr old who is working for my company. She has a 45 degree lumbar curve from T11-L4 with disc degeneration already at L4/L5. I fought my healthcare company, United Healthcare to consider her for VBT due to her clinical status and the fact that she met every criteria of their policy but her age, but each appeal was denied as not medically necessary. Even with our company president writing in and senators flagging the case at the Dept of Finance and tagging UHC on Instagram. Their medical director saying in a peer to peer that if this was his daughter he would totally want VBT but it’s their policy so no. Wouldn’t he push to change to policy to give his kid a chance? Even the NYS external review was denied- reviewed by someone who was not even a spinal doctor. (Absolutely unacceptable).

So now we face fusion as we are left with no choice. I have so much fear about a fusion above degenerating discs. We are at a loss.

She cried in my arms this morning saying “how will I have a life- how will I hold a job- I’m in so much pain”

We are in NY. We will have a call with our surgeon tomorrow and I made an appt with another excellent surgeon at a different hospital as well just to get a second opinion.

Is fusion truly our only option for a 22 year old with great flexibility? Bending X-rays show possible correction from 45 to 17.

Anyone have disc replacement and fusion ?

Feeling I failed her.

Anyone here have lumbar VBT or apical fusion in their late teens or as young adults ? If so please advise how well the surgery went and what life is like now?

Hello

My young adult child with an almost 50 degree lumbar curve has been repeatedly denied for VBT with our insurance despite being an excellent candidate. Today our surgeon suggested maybe we try to get Apical Fusion approved and move forward with that. I just watched Dr Lee’s interview with Dr Trobish in Germany from I believe a year ago

Does anyone know the CPT code? I’m concerned as tethering is still involved and wouldn’t that also be denied?

Our surgeon has not performed many apical fusions at all and I’m concerned.

Has anyone on this group had Apical Fusion - how did it go! can you tell me who performed it and if it was easily covered by your insurance?

Plz talk me off the ledge

🥹

Hello

My young adult child with an almost 50 degree lumbar curve has been repeatedly denied for VBT with our insurance despite being an excellent candidate. Today our surgeon suggested maybe we try to get Apical Fusion approved and move forward with that. I just watched Dr Lee’s interview with Dr Trobish in Germany from I believe a year ago

Does anyone know the CPT code? I’m concerned as tethering is still involved and wouldn’t that also be denied?

Our surgeon has not performed many apical fusions at all and I’m concerned.

Has anyone on this group had Apical Fusion - how did it go! can you tell me who performed it and if it was easily covered by your insurance?

Plz talk me off the ledge

🥹

Surgeon is sending a medically necessary appeal for denied VBT. Office said they are copying the hospitals billing dept.

What is the purpose of that? They didn’t explain.

How does one get all else covered if the insurance won’t cover the VBT itself?

Thx