How to find medical research info question

Factual Questions
1

First, let me apologize if this has been asked before. I am unable to do an exhaustive search on here or google or anywhere else at the moment, and I need some answers yesterday, if at all humanly possible. So, I am turning to all of you, and asking for whatever help you may be able to offer. I must also add that this is not a plea for pity or sympathy or whatever. Just constructive help, if anyone can.

Brief synopsis:
Multiple vehicle accident on July 2, 2001, involving myself in a minivan, 3 other vehicles and a Pepsi 18 wheeler. Slowly progressively worsening back challenges; inventive stall tactics by Pepsi’s ins. claim adjuster; think I got screwed in part by them, my lawyer, and inadvertently my back doctor (long story). Finally got some money in a hush hush settlement last Dec; most of that pittance is gone.

After many tests, and shots directly into my disc and facet joints to numb the pain, my back doctor has decided my best option is a minimally invasive procedure called Intradiscal Electrothermal Therapy. One needle-type thing into the torn, herniated disc (L4-L5) to correct the problem, 4-6 wks in a back brace taking it easy, and I should be 80-90% better than I am now. This procedure has a 70-85% success rate.

The only alternative he can see is to open me up, remove the disc, fuse the vertebrae; perhaps a week in the hospital, minimum of 6 months recovery time, and at best a 50-50 chance of success, and I may still end up with a walker or in a wheelchair. I’m sure you can guess which I would much prefer.

Now comes the problem I need help with. Mr Bear is retired AF, and the military medical system (TriCare Prime) is refusing to pay for the first, saying it’s still considered somewhat experimental; but they would be glad to pay for the second. I am going to appeal, but I must have all the ammo I can get my hands on to strengthen my case. From what I can find out from the local office, the only info they would really be interested in that may help me is research studies that show how safe it is, how many have had it done, what the success rate is, how long have those patients been followed after, that sort of thing.

I am hoping that I will be able to buy a new office chair that my back will let me tolerate in the next week or so. In the meantime, I can only sit here for very short periods of time. Add to that, this computer is on the fritz; no idea if it is a virus that has corrupted it, or it’s in its death throes or what is wrong. All the computer geek friends I have asked have no idea what is wrong. I am far too computer challenged to have a clue myself. I only know that it acts up all the time, and forces me to reboot anywhere from 3-5 times a day to as much as 20-30 if I dare to open too many browser pages (one at a time, or several, makes no difference to how finicky it is). And it hates popups even more than I do. I’d just replace this stupid thing if I had enough money to get a decent one right now.

All this to say I am unable (for some other health issues as well, I’d just as soon not go into here right now) to do my own research in anything remotely resembling a timely fashion. Hubby is willing, but has been so tired when he finally drags in from work, I have been loathe to remind him this past week. Meantime, I have a limited amount of time in which to file an appeal.

Any and all help would be appreciated more than I can tell you. Even if you could just find some sites with study info for me to go look at, that would help enormously. I know I am asking an awful lot, and that is not what this forum is really for. But I don’t know what else to do. They did tell me that any studies that have been done on this procedure would help my case, whether in the US or any other country.

Wow. Re-reading this it sounds a bit like a pity party to me. I assure you, that is not my intent. Just wanted you to know the facts.

You have my profound thanks, for any help any one can offer. And all the virtual hugs you could want. And IRL ones too, if you live close enough, or we meet at a dopefest sometime. Thank you. God bless.

2

Here’s the PubMed site. When I entered the term in the search box, I got some hits, including one concerning worker’s comp.

3

Thank you! I wil check it out ASAP.

{{{{{cher3}}}}}

4

As an additional bit of stuff, here is a summary in layman’s language of a meta-analysis of the procedure you describe or a similar one. A meta-analysis is an analysis of the quality of several studies, and discusses the quality of those studies as well as the results.

The full text of the meta-analysis in all it’s highly technical glory can be obtained as an adobe-acrobat (PDF) format file from a link near the bottom of the link I gave you.

It is not a rosy and glowing report - but then, I trust will want to hear from critics as well as cheerleaders of this sort of procedure.

The meta-analysis was published in February of this year, so it is quite recent. It’s conclusion is, as I read it, that the procedure seems promising but it is not yet proven better or even as effective as traditional treatments.

5

As an additional bit of stuff, here is a summary in layman’s language of a meta-analysis of the procedure you describe or a similar one. A meta-analysis is an analysis of the quality of several studies, and discusses the quality of those studies as well as the results.

The full text of the meta-analysis in all it’s highly technical glory can be obtained as an adobe-acrobat (PDF) format file from a link near the bottom of the link I gave you.

It is not a rosy and glowing report - but then, I trust will want to hear from critics as well as cheerleaders of this sort of procedure.

The meta-analysis was published in February of this year, so it is quite recent.

I also feel compelled to add that yes, I do work for these people, that’s how I know about the report.

Please, seek multiple opinions before ANY back procedure. They are all serious, all have potential side effects, and should not be undertaken lightly.

6

Thank you so much, Broomstick. Yes, I do need to hear both sides of this, the good and the not-so-good. Though of course, I only want to pass on the good in my appeal, at this point. I’ve done a lot of thinking about it, you see. Worst case scenario for me is that if the IDET doesn’t work as well as I hope, then they can elect to do it one more time, or I still have another procedure they can do, the spinal fusion. If they only do the spinal fusion, and it doesn’t work, I’m just SOL; with no where else to go. Once they remove the disc, it’s gone for good.

I would dearly love to get several opinions about this, trust me. However, TriCare, in its infinite wisdom, will not pay for a second opinion outside of the military. And the wait to get into Orthopedics at Wilford Hall Medical Center on Lackland AFB is approx. 3-4 months. Being the spouse of a retired military member, you see, I am at the very bottom of the totem pole. You know, the one they claim does not officially exist. Sorry, that was snarky of me. Guess my frustration at all this red tape is showing.

In the meantime, I will read through these links as I can, or have hubby do some, and see what I come up with. Again, thank you so much for the help. It means so very much to me.

{{{{{Broomstick}}}}}
Btw, Broomstick, I notice you live in Ind. I was born at the old Bunker Hill AFB at Kokomo, a few decades ago. :slight_smile:

7

Actually, there IS another procedure that involves replacing the misbehaving disc rather than simply removing it. However, that one really IS experimental at this point.

I know you’re frustrated with the whole situation, but again, please move with caution. Good back surgery is a life-transforming miracle. Bad back surgery is something you most certainly want to avoid. I know you’re miserable now, but when we work on research projects we always wind up hearing about folks in absolutely horrific states. Please be careful, you certainly want to make sure things aren’t made worse.

On the upside - there are instance where back fusion does work well. One of our docs at work had it done about six months ago and has enjoyed vast improvement. His back will never be quite the same as before, of course, but the pain is much, much diminished. So done appropriately and done well it can be a good thing.

Also - the full version of the report I linked to has several pages of references referring to studies in peer-reviewed journals, which would be the sort of evidence you need for an appeal of benefits. They’re way in the back, the last few pages. By all means, exhaust every appeal option you have.

8

Replacing the damaged/misbehaving disc? Wow. That is news to me. Of course, you do bring up several excellent points, Broomstick. Unfortunately, what is making me very nervous about letting them cut me open is the fact that the only back surgeries I’ve heard about have either a great outcome or a really bad outcome. Nothing much in between. Not sure I like 50-50 odds, when it’s my back.

Thank you for the advice, I will continue to look over the link you offered, as well as the links given by cher3. Especially the last few pages, that does sound interesting.

I’m sorry I was unable to be on here yesterday.

purrplebear, still determined…