I am a worker's comp case with chronic work-related low back pain. I've been looking into getting a disc replacement. Are worker's comp patients even considered for this type of operation?

Patients who are candidates for total disc replacement (TDR) aren't usually determined based on who is the third party payer. Insurance eligibility is a separate decision from qualifying for the procedure.

Sometimes, there are concerns about secondary-gain issues for Worker's Compensation patients. Each program is run differently depending on the state in which you live. If you are considering this option, then you'll be subjected to two separate assessments. One is whether or not you are a good candidate for the operation. The surgeon makes this decision.

There are several clinical guidelines (including contraindications and indications) currently used in this assessment. Patients with scoliosis or other spinal deformity, lumbar spinal stenosis, and disc herniation with sciatica are not considered good candidates for TDR.

Likewise, anyone with spondylolysis, spondylolisthesis, facet joint degeneration, or osteoporosis is not a good candidate either. Spinal instability for any reason and spinal infection also exclude patients from having a TDR.

The other major deciding factor is whether or not the Worker's Comp program in your state covers this service. It may be approved on a case-by-case basis. You will have to contact your Worker's Comp case manager to find out if you are eligible for a disc replacement.