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Medical

• Why is Endoscopic surgery at Laser Spine Institute better for me than other surgical options?
  At LSI, we use technologically advanced, minimally invasive spine procedures to treat spinal conditions with very little blood loss, scarring or scar tissue, and we do not introduce anything to cause any potential problems such as hardware.
• What are the risks of your laser spine procedures?
  Our surgery complications are generally very low compared to traditional open back surgery. Our procedures are minimally invasive and require a very small incision. There is no general anesthesia used which can be high risk in some patients. Post operative infection at the incision site is a complication that rarely occurs.
• What type of anesthesia is used for these spine procedures?
  The patient is sedated and comfortable throughout all of our spine procedures. After IV sedation, a local anesthetic is administered at the surgical site and intravenous medications are used to make the patient comfortable. Laser spine patients are able to communicate with the surgical team throughout the spine procedure and relate to the team when pain has been alleviated and a nerve impulse is moving the length of the nerve.
• I have spinal stenosis or foraminal stenosis, can I be helped?
  Yes, our techniques work well for these conditions. LSI can remove impingements to the spinal or foraminal canal and free the nerve, thereby relieving the pain and symptoms.
• How many spine procedures will I require to solve my back or neck pain?
  Back and neck pain is very individualized as to how many procedures will be needed. During the initial evaluation, it will be determined how many levels of damage you have that are causing symptoms. In most cases, problems are found at multiple levels, but only one or two of them may be causing symptoms. Most patients just need one surgery but many have multiple procedures within that surgery.
  
  Those patients who have multiple pathologies occurring at once may require a combination of techniques that include, for example, both a foraminotomy and a laminotomy. These procedures can be done concurrently by our surgeons at LSI so that you are in the operating room only once and your recuperation, time and costs are kept to a minimum.
• Can you help me if I have had failed open back surgery?
  Yes, we typically can – in fact, a large percentage of our patients have had failed back surgery in the past or have new spine conditions due to fusions. Laser Spine Institute's procedures can correct most spinal conditions, plus our surgeons can remove unwanted hardware that is causing additional spine conditions. Scar tissue development from a previous open back surgery can also cause new and painful spine conditions and can be removed by our surgeons at LSI.
• What medications should I avoid prior to having your laser spine procedures?
  You must be off of all aspirin or anti-inflammatory drugs (or any combinations drugs with these in it) two weeks prior to coming for surgery. These medications thin your blood. Coumadin is a strong blood thinner and if you are on this medication, please consult your doctor about discontinuing it prior to coming for your surgery. If you are taking any other medications, please inform us at the time you are scheduling laser spine procedures, so we can advise you about them on an individual basis. Our nurse will give you detailed instructions prior to and after your laser spine surgery.
• How soon after surgery can I drive?
  Due to the IV sedation and local anesthetic that we utilize, you are able to return to normal driving and other activities of daily living within twenty four hours of your procedure.
• If I have cervical surgery, how long will I have to wear a neck collar?
  A cervical collar is required to be worn for the first two weeks after surgery. Patients are instructed to wear the collar if they are sitting or walking for an extended period of time, such as working at a desk or driving in a car.
• How is the Laminotomy procedure different from a Laminectomy?
  To open up the spinal canal, we use an endoscopic approach for laminotomies-without the need for general anesthesia. We do not perform laminectomies. A laminotomy is a surgical procedure that is used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord, increasing the amount of space available for the neural tissue and thus releasing the nerve(s). The term laminotomy is derived from the Latin words lamina (bony plate that covers the posterior arch of the vertebra) and -otomy (act of cutting, incision). Another type of surgery called a laminectomy is a procedure used in traditional open back surgeries that involves removing the lamina to increase the amount of space available for the neural tissue. The term laminectomy is derived from the Latin words lamina (thin place, sheet, or layer), and -ectomy (removal).

General

• What do I have to do to find out if I am a candidate for Laser Spine Procedures?
  You can go to our Contact Us page and give us a call or submit your information and questions by e-mail through our website. One of our patient advocates will contact you at the time and manner in which you request and answer your questions. After that, if you would like a Free MRI Review to determine if you are a candidate for our procedures, all you need to do is fax your MRI Report and one of our medical staff will review the report, determine if you are a candidate, then call you to discuss your condition and what LSI procedure(s) will help you. It's that easy and at no cost to you for this review and discussion with one of our staff members.
• If I'm coming from out of town, how long will I have to stay in your area?
  This is outpatient surgery, so there is no overnight stay at our facility. If you are from out of town, you will need a local hotel room for the length of your stay. There are numerous hotels within 1 mile of LSI.
  
  There are two pre-op days of testing, the surgery, followed by two days of physical therapy. If a second surgery is needed, the process would repeat. Pre-op testing does not have to be repeated if more surgery is required within a thirty day period. In general, a patient is looking at staying in our area for one week per surgery.
• What are my limitations after laser spine surgery and how long will I be out of work?
  Physical therapy begins the very first day after your procedure. We want you to limit lifting over 10-15 pounds for about six weeks. We recommend that patients return to normal activities gradually to allow for maximum healing. Patients that have desk jobs can normally return to work within a few days and patients with physically strenuous jobs should wait six weeks, depending on the job. You may return to work with restrictions for those first six weeks and then return to normal activity there after.
• What arrangements do I need to make to have surgery at Laser Spine Institute?
  You will need to have someone available for you after your surgery to either drive you home (if you are local) or stay with you at a local hotel (if you are from out of town). Your patient advocate will assist you in making arrangements.
  
  You will need to bring all medications you are currently taking.
• Why don't more surgeons use these types of techniques?
  These sophisticated procedures are difficult to learn and take years of training. They are on the cutting edge of medical technology and LSI is at the forefront of this movement. We see this changing in the future as this will become the standard of practice for surgical intervention of spinal conditions throughout the world. Until then, LSI is here to relieve the pain and suffering of people with spine conditions in the most effective, efficient and gentlest methods possible.
• Why aren't more surgeons around the country using these types of procedures?
  Due to the nature of this procedure, it takes a highly skilled and well-trained surgeon to utilize the laser as a primary surgical instrument through such a small incision. At this time, the procedures performed by the surgical team at LSI are not taught in medical school. A surgeon must be professionally trained by a certified doctor in the specialty of minimally invasive endoscopic spine surgery in order to master the technique. We are fortunate to have seven professionally trained surgeons operating at LSI that are enjoying positive results.
• May I request a specific surgeon?
  Yes, patients can make a request on which surgeon they would like to perform their surgery at LSI, however we cannot guarantee that a specific surgeon will definitely perform all the procedures. Since the surgeons operate as a surgical team, it is not unusual for multiple surgeons to perform different procedures on the same patient. Every patient is different due to their anatomy or history of physical symptoms, therefore every case is reviewed by each surgeon and delegated according to each surgeon's specialty and the availability in the schedule.

Insurance

• What are the costs of your endoscopic spine surgery?
  Laser Spine Institute accepts most health insurance. Therefore, many patients are only responsible for their out-of-pocket expenses. Your maximum financial responsibility will be determined by your individual health insurance coverage. To quickly confirm your benefits, call our helpful Patient Coordinators today at 1-866-276-5320.
• Is Laser Spine Institute in contract with every insurance provider?
  Though Laser Spine Institute accepts most health insurance, we are currently in contract with UnitedHealthcare and its affiliates, plus a number of leading preferred provider organizations. Your financial responsibility for endoscopic spine surgery will be determined by your individual health insurance coverage. To determine your out-of-pocket expenses, call our Patient Coordinators today at 1-866-276-5320, and they will quickly confirm your benefits.
• Why isn't the Laser Spine Institute in contract with Medicare for the facility fee?
  The Laser Spine Institute physicians are in contract with Medicare for the professional services that they provide. However, the LSI facility itself is not in contract with Medicare so a facility fee is incurred by the Medicare patient as an upfront out of pocket cost. LSI has the strongest desire to provide every patient with not only the most professional and qualified service from its surgeons and staff, but with the most state-of-the-art amenities and equipment from its cutting edge facility.
• Will I be able to know exactly how much reimbursement I will receive from my insurance provider prior to surgery?
  We at LSI are unable to make any guarantee of the exact amount of reimbursement each patient will get back from their insurance company due to the fact that each insurance company and each insurance plan is different. Our patient advocates and patient coordinators do provide each patient with the appropriate CPT codes for each service provided to use in contacting their insurance provider. Those codes can give each patient an idea of how much reimbursement they may receive from their insurance according to what is usual and customary under their plan. Additionally, we have an insurance verification and pre-certification department that will verify your insurance benefits and assist in determining your total reimbursement.

Workers Compensation

• Does work comp pay for the LSI procedures?
  In most cases the worker’s compensation carriers will only pay at state fee schedule rates. Unfortunately, at LSI our procedures cannot be reimbursed at fee schedule rates. The cost of the evaluation and subsequent treatment will need to be approved before the evaluation takes place.
• My carrier wants codes and fees submitted what do I do?
  Please contact LSI at wcinfo@laserspineinstitute.com to have codes and fees for the LSI procedures sent to your carrier.
• Are the LSI procedures experimental or investigational?
  The surgeries performed at LSI are not experimental or investigational and are recognized by many guidelines used in work comp. The technique of entering and exiting the spine are unique.
• If work comp will not approve my evaluation are there other options?
  If you received a denial from your carrier and would like to discuss other financing please call 1-866-LSI-DOCS
• My carrier approved my evaluation, what is the next step?
  Please fax the signed authorization letter to 813-418-4317 and a representative will call you to schedule the evaluation
• I only want an MRI reviewed by the LSI doctor, what do I do?
  Please fax the MRI report to 813-418-4317 and note that you only want an MRI review.
• My adjuster wants more information, what do I do?
  Please submit your request by emailing our workers' compensation department at wcinfo@laserspineinstitute.com. Please include the adjusters name and phone number and your name and claim number.
• Do I need a referral from my work comp doctor?
  Yes, in most states a new facility will need to be recommended with a referral from your treating doctor. You can discuss this with your adjuster or claims examiner.
• Does the Laser Spine Institute work with Federal Employees through the Department of Labor?
  The staff at LSI would like to work with injured federal employees, but we are not able to accept the federal fee schedule reductions and are not a part of the ACS. Please speak to your claims examiner to discuss treatment out of network.