With additional inputs from Dr.Deepu Sebin Sebastian
Hello,
Thank you for asking your query at DoctorSpring.
My apologies for the delay in reply.
"Spinal Herniation" is an incorrect term. Do you mean spinal disc herniation ? This is a condition in which the disc between two spines bulge out causing various manifestations.
Precise name and details of the condition is important as we are dealing with an insurance case. Could you please confirm the diagnosis ? Also what are specific issues you are facing while filing for insurance approval ?
(I assume the issue is whether the Disc herniation is pre existing or is it new due to bicycle accident. Please let me know whether my assumption is correct)
You can reply as a followup
Thank you
Patient replied :
Hello Doc! thanks for your reply!
Well yes i have a spinal disc herniation sorry for the incorrect term.
The principal problem is that my insurance is refusing to pay me as an accident because they say that is a desease.
In 2011 i was mountain biking,when i finished riding i lift my bike to put it on the rack and i felt a veeeeeeeery intense pain in my back, so i went to ER because I could not stand the pain, they give me pain killers and 2 weeks of rest so i got well after that, but not a 100% i always fell a little pain in the same area since that accident.
This Year that pain was stronger so i decided to go with my doctor to see whats happening in my back and he told me that i have 3 spinal disc herniations,he told me to do physiotherapy and rest.
The big problem is when i claim to my insurance all my expenses, they say that is not an accident, then i fight with them and they told me that i will have to ask my doctor to make a report, telling the insurance company that in fact my actual condition is because of that accident back in 2011, buuuuuut my freaking doctor doesn´t want to make that report because he said that 100% of spinal hernias are diseases and they are not caused by any type of accident, so i want to make a research to show my doctor that he is wrong. Can you help me???
thanks
Hello,
Allow me list down my opinions for clarity:
1. Spinal disc herniation is a disease of degeneration and wear and tear in most of the cases. However spinal disc herniation can occur due to trauma and accident. This is called traumatic disc herniation. You can find case reports at http://www.ncbi.nlm.nih.gov/pubmed . Use terms like traumatic spinal disc prolapse/herniation, traumatic lumbar disc herniation/prolapse etc. to find case reports. These reports might not be similar to your case, but ascertains the fact that accidents can cause spinal disc herniation.
2. BUT, disc herniation of a trauma and disease appears different on MRI . So you Doctor will be able to make out it on the MRI. Chances are that you might have had the disease prior to the accident, which was unnoticed. The accident could have made it worse and caused further damage.
3. Unless you had an MRI at the time of injury, with features highly suggestive of traumatic disc prolapse, your Doctor might not give a favourable report. Even if the Doctors files a favourable report, chances are that it will be again thoroughly verified by the insurance company.
4. I understand this is unfair, as the accident brought out the symptoms. You should discuss with your Doctor whether the MRI shows signs of degeneration or trauma. (May be a Radiologist will be able to answer it better). If it shows signs of trauma you have a better chance.
Hope this helps.
Please feel free to ask followup questions.
Patient replied :
Hi Doc!!!! thanks very much you are helping me allot!!!!
I want to send you my MRI so you can have a better view of my case and maybe you can define if my problem is a desease or caused by the accident, but i dont know how to scan them, maybe a will take pictures with backlite
THANKS!
BEN
Hello,
Sure, if you can scan them or take pictures. You can ask the MRI lab if they could assist you.
Regards