Does Health Insurance Cover A Fusion?

by | Last updated on January 24, 2024

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For patients not covered by health insurance, spinal fusion, typically used to treat conditions such as a slipped vertebra, fractured vertebra or other spinal instability, typically costs

$80,000 to $150,000 or more

; a surgery in which high-end titanium implants are used instead typically will fall on the higher end.

How long does a spinal fusion surgery take?

Spinal fusion surgery usually takes

four to six hours

, but the time varies according to the individual patient. The surgeons will take as long as they need to do the job well.

When should spinal fusion be considered?

Spinal fusion is best for

treating low back pain caused by severe degenerative disc changes

and is best for treating one, or maybe two, levels of the lower spine (typically the L4-L5 level and/or L5-S1 level).

Is spinal fusion medically necessary?

Spinal fusion should only be considered as a last step in the treatment of chronic back pain and is not indicated for most persons suffering from back pain. Lumbar spinal fusion surgery

may be considered medically necessary

and covered for the following indications: 1.

Is a spinal fusion major surgery?


Spinal fusion is major surgery

. It usually lasts several hours. It involves making a cut in your back or your belly, or sometimes both. The cuts, called incisions, leave scars that fade with time.

What is the success rate of spinal fusion surgery?

Depending on the condition the surgery is treating, spinal fusion has a

70 to 90%

success rate.

How long is a hospital stay for spinal fusion?

Hospital recovery after a fusion surgery focuses on managing pain and learning how to move safely while the lumbar spinal fusion solidifies. solidifies. A hospital stay of between 2 and 4 days is typical.

How painful is spinal fusion recovery?

After surgery,

you can expect your back to feel stiff and sore

. You may have trouble sitting or standing in one position for very long and may need pain medicine in the weeks after your surgery. It may take 4 to 6 weeks to get back to doing simple activities, such as light housework.

How long do you have to wear a brace after spinal fusion?

After spinal surgery, patients in the brace group were instructed to wear a rigid brace (Knight-Taylor [chairback] brace) full-time for

12 weeks

, except when bathing or lying in bed. Knight-Taylor [chairback] brace, is one kind of rigid lumbosacral orthosis.

Who is not a candidate for spinal fusion?

Who is NOT a good candidate for spinal fusion? You may not be a good candidate if:

You have been having back or neck pain or symptoms for less than six months

. Your spine condition affects discs or vertebrae at multiple levels of your spine.

Who is a good candidate for spinal fusion?

An ideal spinal fusion candidate is

one who has tried a couple different conservative techniques without success

. Ideally, those non-surgical interventions will take care of the issue, but if they don’t, then you can be considered for a spinal fusion operation.

What happens if I don’t have spinal fusion?


A nonunion occurs If the fusion surgery doesn’t “take” or unite

. This is another reason to avoid a fusion whenever possible. When a fusion fails, you are generally in need of an additional fusion surgery to stabilize the segment of the spine that moves too much (nonunion).

Can you live a normal life after spinal fusion?

Even people requiring bigger surgeries like spinal fusion are

90% likely to return to work and stay at work long term

. While most people recover from back pain through exercise and healthy lifestyles, those who require surgery can expect to return to work and “get their life back” too.

What is a 3 level spinal fusion?

Multilevel spinal fusion refers to

fusion of more than one spinal disc level

(e.g. L3-L4 and L4-L5 fusions). When a multilevel spinal fusion is performed, it is almost always on contiguous spinal levels. The most common levels included in a multilevel spinal fusion are L4-5 and L5-S1.

Can spinal fusion cause problems later in life?


A patient may experience recurrent pain many years after a spine fusion surgery

. This can happen because the level above or below a segment that has been successfully fused can break down and become a pain generator.

Is spinal fusion a high risk surgery?

Spinal fusion surgery is generally a very safe procedure, and advances in minimally invasive techniques have allowed fusions to be performed using smaller incisions, causing less trauma and reducing risks further. However, as with all forms of surgery,

there is the potential risk of complications

.

How do you sit on the toilet after back surgery?


Use an elevated toilet seat or commode to raise the level of the toilet

. Do NOT lean over your legs while sitting. 2. Wear your brace while using the bathroom.

What is a 360 spinal fusion?

360 Fusion (ALIF & PLF) is

a minimally invasive procedure that restores spinal stability and provides pain relief by fusing both the front and back of the spine

.

Who performed Tiger Woods spinal fusion?


Richard Guyer

was Tiger Woods’ Back Surgeon, who successfully performed the minimally invasive lumbar interbody fusion surgery.

Can you feel the screws after spinal fusion?

Often,

excessive pain is a symptom of a loose screw after spinal fusion or other hardware complication

. “If the hardware is prominent under the skin the patient may feel a painful bump,” Dr. Lieberman explains.

Do you get a catheter during spinal fusion surgery?

Your back will be washed before starting the surgery. The surgery usually takes about 4 hours, but you will be in the operating room a total of 4 to 5 hours.

A tube, called a Foley catheter, is placed in your bladder while you are asleep

.

Will I need a walker after spinal fusion?

Your physician will encourage you to walk as much as possible.

You will need an assistance device such as a walker or cane for the first week

; however, you should strive to limit the use of this device after the first two to three weeks when you are on stable ground.

How long does it take to walk after spinal surgery?

You’ll be encouraged to walk and move

around the day after surgery

and it’s likely you’ll be discharged 1 to 4 days afterwards. It will take about 4 to 6 weeks for you to reach your expected level of mobility and function (this will depend on the severity of your condition and symptoms before the operation).

How far can you walk after spinal fusion?

Gradually increase the distance you walk and, if weather permits, you may walk outside. You should be able to gradually increase your distance until you can walk

about one mile within one to two months after surgery

. Ladies avoid high heels for the first month after surgery.

Can you cross your legs after spinal fusion?


Never cross your legs

. Adjust the backrest to support your lumbar spine (at waist level). If your seat is not adjustable, use a folded/rolled towel or pillow for support in the small of your back.

Why do my legs hurt after spinal fusion?


The formation of scar tissue near the nerve root (also called epidural fibrosis) is a common occurrence after back surgery

—so common, in fact, it is so common that it often occurs for patients with successful surgical outcomes as well as for patients with continued or recurrent leg pain and back pain.

Diane Mitchell
Author
Diane Mitchell
Diane Mitchell is an animal lover and trainer with over 15 years of experience working with a variety of animals, including dogs, cats, birds, and horses. She has worked with leading animal welfare organizations. Diane is passionate about promoting responsible pet ownership and educating pet owners on the best practices for training and caring for their furry friends.