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Laser Spine Institute in Tampa, FL
Has anyone on this forum been treated by the Laser Spine Institute in Tampa for spinal stenosis? My father is scheduled for a procedure there and I have some concerns about the center based on the way they have treated him so far. Any input would be appreciated :)
We have Cigna and our insurance sees this as an option BCBS -I have friends who also had procedures from LSI and are doing great and it was relatively inexpensive
Are you referring to the succession of treatments like PIRT, or the fact that major insurance companies (BCBS, Cigna, UHC, etc.) have deemed this treatment to be "not medically necessary", in spite of the fact that IDET and similar non-invasive treatment of tears in the annulus fibrosis have been proven to reduce discogenic pain in over 60% of people who have undergone the procedure?
IDET is no longer practiced as of 2015. Not sure why you are bring that information up. I had it in 2000 and it did help me and kept my legs from giving out on me. But the professionals have moved on from this procedure.
Go get a drink and sit down. This is going to be long.
I have seen their TV commercial and my first impression is that they're too confident about presenting positive outcomes for too many back problems. I general, treatment outcomes come with a percentage of success vs. a percentage of risk. The patient must make an informed decision as to whether the risk is worth the benefit in any medical treatment.
The word "laser" means little. A laser can cut or a laser can heat. Most doctors who do procedures, including surgical procedures have their choice of a variety of tools, some of which would serve these same functions.
Let’s look at heat treatment. There are techniques, one of which is called IDET, (Intra Disc Electro Thermal therapy), that treats mild-moderate degenerative disc disease. IDET involves heating the outer ring (annulus fibrosis) of an intervertebral disc that exhibits cracks in this ring. Diagnosing these cracks involves a procedure called a ‘discogram’ that involves injecting die into the disc space under fluoroscopic guidance and observing the patient for signs of pain.
IDET is still in its infancy and studies in large patient populations with back pain have not yet been completed. Thus, IDET is still an unproven technique for the general population of people with LBP and disc disease.
Now, let’s look at cutting procedures, ie, surgery.
The outfit treating your father claims to treat a long list of severe spine conditions in their ads, one of which is lumbar spinal stenosis, which is a painful, debilitating disease. I live with it and know all about the pain it causes. Every movement is painful and one cannot find a comfortable position.
People with severe cases of lumbar spinal stenosis are in pain, constantly. Many people with LBP these days do not receive proper pain management for their condition and are desperate for solutions. They are desperate to escape the constant pain.
Desperation causes one to make bad decisions, and it is here where you can help your relative. Remember that I’m speaking in general, without any knowledge of your relative’s condition or the extent of their disease. I’m also not offering medical advice, but my personal experience, and my experience with people I’ve spoken with, including many doctors who are involved with LBP and lumbar spine disease.
Surgical solutions are sometimes necessary to stabilize the spine, ie, to make sure the bone and muscle structure can support the upper body and head, and to prevent injury to the spinal cord and/or nerve roots that can cause serious problems like paraplegia.
When surgery is required to save the spine, there is no hesitation – it must be done. ASAP!
However, this is not often the case. A good doctor will tell you the seriousness of your case without bias toward his performing the surgical procedure.
Often it requires a lot of effort and money to find the correct answer when seeking the best medical treatment. I like to tell people that you need courage, confidence, and perseverance in solving your pain problem.
You also need knowledge about the nature of your pain, understand the involvement of your underlying disease state, and be aware of all possible treatment options, knowing both risks and benefits involved.
This takes time and experience. It also requires a lot of reading. I’m sharing knowledge here that I’ve acquired in over 30 years as a pain patient, and in counseling hundreds of people online who also suffer from pain and spine disease.
Let’s get back to your relative.
Certain surgical treatments for spinal stenosis can be debilitating and have long recovery times. Sometimes they don't improve pain, but exacerbate it. Other surgical procedures can work very well.
Every case is different. There is no "one size fits all" in the treatment of serious back disease and chronic pain. Don’t believe in any “magical” cure. There is no easy answer for most of us.
Simply put, some treatments work and some do not. Sometimes there is no appropriate surgical treatment. But as a patient who has to live with the consequences, it is expedient to understand exactly what you seek, and seek relentlessly for pain relief. Untreated pain leads to the incurable disease of the nervous system called Chronic Pain Syndrome.
Doctors are very practical people. They work slowly and deliberately, eliminating a list of possible conditions until they arrive at an accurate diagnosis. If they're good at their work, they then match their patient with treatments that will provide the best chance of a positive outcome. If they’re ethical, they will suggest treatments without regard to their personal benefit, but if they are human, they may be subject to some degree of bias in their favor, however slight. Be aware.
In your relative’s case, a positive outcome means both a stable spine, and some degree of relief from pain.
Unfortunately, people with serious back disease cannot always expect to be 100% pain free after any treatment. People with the disease called chronic pain syndrome, no matter what the source of their pain, can expect to live with a certain amount of pain for the rest of their lives.
Now, here we are at the end of this long letter, and I can't advise you on whether or not that outfit is doing the right thing for your relative.
One thing you can do is get a second opinion from an objective spine doctor. I suggest seeing a specialist trained in pain management and the spine. These doctors are a board certified pain medicine specialists, credentialed with the initials MD, DABPM after their name. This means they have a diploma from the American Board of Pain Management. They are not surgeons.
These are doctors who are trained in advanced anesthesiology and treat chronic pain as a disease – not a symptom. They have a thorough understanding of the nervous system, the spine, the use of advanced pain medication, and are trained in techniques that can deliver pain relief with injections and other non-invasive procedures to specific areas of the body. They are also experts at diagnosis of rare pain syndromes, like central pain, CRPS, and RDS.
And, they treat LBP all the time.
Unless surgery is a medical necessity to save the spine, I prefer waiting and using all non-invasive therapies until they are exhausted and no longer work. This is what I’ve done for all these years and as I said earlier, so-far, so-good. I first started experiencing cervical pain in 1980.
In my opinion, surgery, unless a medical necessity to save the integrity of the spine, cord, or nerve roots, should always be a treatment of last resort.
I have seen their TV commercial and my first impression is that they're too confident about presenting positive outcomes for too many back problems. I general, treatment outcomes come with a percentage of success vs. a percentage of risk. The patient must make an informed decision as to whether the risk is worth the benefit in any medical treatment.
The word "laser" means little. A laser can cut or a laser can heat. Most doctors who do procedures, including surgical procedures have their choice of a variety of tools, some of which would serve these same functions.
Let’s look at heat treatment. There are techniques, one of which is called IDET, (Intra Disc Electro Thermal therapy), that treats mild-moderate degenerative disc disease. IDET involves heating the outer ring (annulus fibrosis) of an intervertebral disc that exhibits cracks in this ring. Diagnosing these cracks involves a procedure called a ‘discogram’ that involves injecting die into the disc space under fluoroscopic guidance and observing the patient for signs of pain.
IDET is still in its infancy and studies in large patient populations with back pain have not yet been completed. Thus, IDET is still an unproven technique for the general population of people with LBP and disc disease.
Now, let’s look at cutting procedures, ie, surgery.
The outfit treating your father claims to treat a long list of severe spine conditions in their ads, one of which is lumbar spinal stenosis, which is a painful, debilitating disease. I live with it and know all about the pain it causes. Every movement is painful and one cannot find a comfortable position.
People with severe cases of lumbar spinal stenosis are in pain, constantly. Many people with LBP these days do not receive proper pain management for their condition and are desperate for solutions. They are desperate to escape the constant pain.
Desperation causes one to make bad decisions, and it is here where you can help your relative. Remember that I’m speaking in general, without any knowledge of your relative’s condition or the extent of their disease. I’m also not offering medical advice, but my personal experience, and my experience with people I’ve spoken with, including many doctors who are involved with LBP and lumbar spine disease.
Surgical solutions are sometimes necessary to stabilize the spine, ie, to make sure the bone and muscle structure can support the upper body and head, and to prevent injury to the spinal cord and/or nerve roots that can cause serious problems like paraplegia.
When surgery is required to save the spine, there is no hesitation – it must be done. ASAP!
However, this is not often the case. A good doctor will tell you the seriousness of your case without bias toward his performing the surgical procedure.
Often it requires a lot of effort and money to find the correct answer when seeking the best medical treatment. I like to tell people that you need courage, confidence, and perseverance in solving your pain problem.
You also need knowledge about the nature of your pain, understand the involvement of your underlying disease state, and be aware of all possible treatment options, knowing both risks and benefits involved.
This takes time and experience. It also requires a lot of reading. I’m sharing knowledge here that I’ve acquired in over 30 years as a pain patient, and in counseling hundreds of people online who also suffer from pain and spine disease.
Let’s get back to your relative.
Certain surgical treatments for spinal stenosis can be debilitating and have long recovery times. Sometimes they don't improve pain, but exacerbate it. Other surgical procedures can work very well.
Every case is different. There is no "one size fits all" in the treatment of serious back disease and chronic pain. Don’t believe in any “magical” cure. There is no easy answer for most of us.
Simply put, some treatments work and some do not. Sometimes there is no appropriate surgical treatment. But as a patient who has to live with the consequences, it is expedient to understand exactly what you seek, and seek relentlessly for pain relief. Untreated pain leads to the incurable disease of the nervous system called Chronic Pain Syndrome.
Doctors are very practical people. They work slowly and deliberately, eliminating a list of possible conditions until they arrive at an accurate diagnosis. If they're good at their work, they then match their patient with treatments that will provide the best chance of a positive outcome. If they’re ethical, they will suggest treatments without regard to their personal benefit, but if they are human, they may be subject to some degree of bias in their favor, however slight. Be aware.
In your relative’s case, a positive outcome means both a stable spine, and some degree of relief from pain.
Unfortunately, people with serious back disease cannot always expect to be 100% pain free after any treatment. People with the disease called chronic pain syndrome, no matter what the source of their pain, can expect to live with a certain amount of pain for the rest of their lives.
Now, here we are at the end of this long letter, and I can't advise you on whether or not that outfit is doing the right thing for your relative.
One thing you can do is get a second opinion from an objective spine doctor. I suggest seeing a specialist trained in pain management and the spine. These doctors are a board certified pain medicine specialists, credentialed with the initials MD, DABPM after their name. This means they have a diploma from the American Board of Pain Management. They are not surgeons.
These are doctors who are trained in advanced anesthesiology and treat chronic pain as a disease – not a symptom. They have a thorough understanding of the nervous system, the spine, the use of advanced pain medication, and are trained in techniques that can deliver pain relief with injections and other non-invasive procedures to specific areas of the body. They are also experts at diagnosis of rare pain syndromes, like central pain, CRPS, and RDS.
And, they treat LBP all the time.
Unless surgery is a medical necessity to save the spine, I prefer waiting and using all non-invasive therapies until they are exhausted and no longer work. This is what I’ve done for all these years and as I said earlier, so-far, so-good. I first started experiencing cervical pain in 1980.
In my opinion, surgery, unless a medical necessity to save the integrity of the spine, cord, or nerve roots, should always be a treatment of last resort.
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