Coflex for stenosis

Hi all. My 51 year old wife is having a neurosurgeon perform a surgical decompression and implant a Coflex device between her lower vertebra on Thursday. She never realized that some of her odd pain/numbness issues in her legs/arms/back were all that serious, but she was diagnosed with a good case of congenital spinal stenosis after a 3T MRI and x-rays. I haven't found much on here about this device (I honestly only briefly searched), but if anyone has any advice and/or knowledge, I'm listening! She was really not wanting a spinal fusion. After watching her dad, who has had one, I can't blame her! I have found out that Carefirst BC/BS doesn't want to cover it (also told they were the only problem the doc's office has encountered from an insurance provider), but we'll deal with that after the procedure.

Thanks,

MD

Hi Susie and thanks.

Though it's FDA approved, Carefirst apparently considers it 'investigative' for her treatment (as opposed to 'experimental' I suppose) and they claim to not cover investigatory treatments. Everything but the installation of the device is covered 100% (already pre-authed, even though my plan doesn't require pre-auths).

The surgeon's office was gathering up the necessary information to make an appeal, and the surgeon is in the process of scheduling a meeting with reps from Carefirst to discuss these apparently ongoing issues, but, we made the decision to cover that specific part of the surgery out of pocket (about $1600) with the hopes it will get reimbursed to us at some point. But, it has to be submitted and denied before we can appeal it. At least if we get it in before year's end, we won't be immediately facing another yearly deductible for the new year, as we've already hit that maximum this year. Besides, she wants it over ASAP so she can hopefully get some relief. According to the doc, she'll be in and out, walking out of the facility under her own power. She'll have to take it easy for a couple weeks, but she'll be able to work from home (no driving allowed).

I don't know if it surprises me or not that Carefirst is the difficult provider here or not.

Thanks for the link. It looks to be informative!

MD

Well, Susie--that just sucks!

I don't know if we'll get the reimbursement or not, but she wanted to try the Coflex in any case.

Surgery was yesterday, late afternoon. It took a bit longer than either we, or the surgeon had expected. They rolled her back at 3:45 pm and she didn't get into recovery until 7 pm. As it turned out, the narrowing of her spinal canal was more than expected and he actually installed 2 of these devices. She had more bleeding/fluid than usual, so he inserted a drain. The 2 hour post-op recovery was extended to 4 hours due to the drain--and that ended up being an overnight stay in the surgical center! It was ultimately our call regarding the stay (but suggested by staff), but probably for the best. No way would she have been able to get comfortable at home. It wasn't the easiest transport home for her this morning (amazing how many bumps there are in the road that we had never noticed before!), but now into the recliner and hoping the muscle relaxers and Percocet (hopefully limited use) do their jobs, and for a successful operation.

Best wishes.

MD

I've had 3 spinal surgeries, all of them disc related, but none what your wife had done. Mine were also expected to be outpatient procedures (though I was told there was a possibility I would end up being kept overnight), but I ended up being kept in the hospital for 2 nights/3 days for two of the surgeries and 4 nights/5 days for one. Having gone through these surgeries, I can't imagine being sent home right after surgery! So it is probably a good thing that you and your wife chose to keep her there overnight. Even just one day makes a difference. I'm glad everything went well, even if a bit more complicated than expected, and I hope your wife's recovery is off to a good start! She's got a long road ahead of her, but hopefully she'll be much better off in the end!

Skeye

MD, very glad to read each day gets a dab better for your wife that is encouraging. Spasms can be a bear long after surgery too, very common. I cannot imagine what the first night at home would have been like. This is why I think some of these surgeries need to be monitored 24 hours then be released. Once that pain level kicks up like that oral meds do not always get the pain down to a tolerable level.

Thanks for keeping us updated. Your post has over 170 views so far, so many people are reading this.