Video Resources & FAQs

We have an extensive list of insurances that we accept which are available on our web site. If there is any question, it is best to contact the insurance directly since they know exactly what type of plan you have. View our list of accepted insurances

We do verify your insurance prior to your appointment and try to give the best possible estimates that we can.

Your insurance claims are processed in the order they arrive at the insurance company. Even though you may have paid your deductible at the facility, it may get deducted from another claim if the facility’s bill does not arrive first.

There are different entities involved in a surgical procedure, all which are billed separately and may not be part of Sonoran Spine Billing process.  You may receive billing statements from separate entities. For example,

• Facility - Location where surgical procedure is performed

• Surgeon -The doctor who performs the surgical procedure. Please note there can be more than one surgeon in attendance.

• Assistant Surgeon - One who assists the surgeon during the surgery procedure if required or requested by the Surgeon.

• Anesthesiologist – One who administers the amount of anesthesia, closely monitors and adjust levels throughout the duration of the procedure.

During the global period after your surgery, no office visits are charged, however, xrays are billed because they do not fall into the global billing category.

Fusing painful joints helps get rid of neck pain. Fusion is appropriate after cervical discectomy or spinal cord decompression in order to stabilize the neck, prevent neck pain, and protect the nerves from getting pinched again.

A. Surgery is appropriate when conservative care has not helped and you decide that you are tired of living with your pain.

A. Surgery is needed in the true sense of the word mainly in three instances, one with paralysis or other neurologic dysfunction, two with infection of the bone, and number three, with instability of the cervical spine.

A. Surgery is appropriate when conservative care has not helped and you decide that you are tired of living with your pain.

A. Surgery is needed in the true sense of the word mainly in three instances, one with paralysis or other neurologic dysfunction, two with infection of the bone, and number three, with instability of the cervical spine.

A. Physical therapy, daily exercises, gentle traction, a cervical collar, medications, and epidural steroid injections can help patients improve without surgery. Passive forceful manipulation of the neck (chiropractic) should be avoided since it can cause worsening and even catastrophic complications.

A. Many patients can undergo pain management, which can include injections. Medications can also be tried. Physical therapy can also be tried to help avoid surgical intervention in patients who have pain that has not been alleviated with rest or time.

A. An MRI provides valuable information about the status of the spinal cord, nerves, disks, and joints in the cervical spine. When abnormalities in these structures are suspected due to the presence of arm pain, numbness or tingling, or severe neck pain, an MRI helps clarify the diagnosis.

A. Pain in the neck proper does not warrant an MRI unless the patient also has neurologic symptoms such as weakness in the arms and legs, inability to control bowels or bladder or pain in a single nerve distribution of one arm. Reasons to obtain an MRI include pain that has lasted for greater than six months and is not relieved by conservative care.

A. Most people return to normal activities including driving by 6 – 9 weeks, depending on the surgery.

A. This depends upon the number of levels fused; however, most patients can get back to some reasonable level of activity within a few weeks.

A. We use a soft collar in some cases to help control the neck and take stress off the neck muscles after surgery. Some patients feel better wearing a collar. After 4 – 8 weeks, the collar is no longer required.

A. This is surgeon dependent. For patients who have anterior fusion surgery at a single level with instrumentation, I do not believe a collar is necessary; however, patients who have over a two-level fusion with anterior surgery, I do place patients in a collar for usually six to twelve weeks.

A. Failure to improve is the most common. Less common complications include failure of fusion, infection, nerve root or spinal cord injury, difficulty swallowing, need for further surgery to extend the fusion, and injury to the adjacent structures in the neck.

A. Anytime we operate on the cervical spine, there is a slight risk for paralysis, continued nerve root injury, non-union of the fusion, failure of the instrumentation, and hardware loosening. Also, in anterior cervical surgery, there is a chance of significant bleeding and injury to a nerve that goes to your voice box.

A. Excellent pain relief with disk surgery occurs in >90% of patients. In our experience, for patients who require more extensive decompression and fusion, the success rates are usually above 80% for most procedures.

A. The chances for complete pain relief for actual neck pain are not great. In most papers reported results decrease the neck pain from 70% to 80% or 85%. If one is talking about relief of arm pain from a herniated disc, that success rate is greater than 90% to 95%.

A. Pain relief is related to the severity of the problem, the occurrence of complications, and a host of other factors. Rest assured that with current techniques, by far the majority of patients are much better after surgery than they were before and would do it all again.

A. Everyone will have some level of discomfort after surgery. This is usually very short lived. Physical therapy usually helps to decrease this even further to the point where most patients do not have significant discomfort after neck surgery.

A. Pain relief is related to the severity of the problem, the occurrence of complications, and a host of other factors. Rest assured that with current techniques, by far the majority of patients are much better after surgery than they were before and would do it all again.

A. Everyone will have some level of discomfort after surgery. This is usually very short lived. Physical therapy usually helps to decrease this even further to the point where most patients do not have significant discomfort after neck surgery.

A. The fusion rates for autograft and allograft for single level fusions is the same. There is pain associated with the autograft harvest site, so we use allograft whenever possible.

A. For a single-level fusion from the front or anterior aspect of the neck, it makes no difference whether you have allograft or autograft. For multi-level fusions, i.e. more than a single level through an anterior approach, it has been shown that autograft is a better choice.

A. Fusing the spine does increase the stress seen by the adjacent disks and joints. Whether this added stress translates into a new source of pain or instability is harder to predict.

A. Fusion in any area of the spine will cause increased stress on the levels right next to it. To that end, those levels will wear out slightly more quickly than if you did not have a fusion.

A. Many of the problems in the cervical spine can be better addressed through the front of the neck, leaving the neck muscles in the back undisturbed. This allows for a quicker rehabilitation of the neck muscles after the fusion heals.

A. Surgery is done through the front of the neck because the disc is often the cause of the pain and/or neurologic dysfunction. Reaching it from the back is dangerous secondary to the spinal cord's being in the path of getting to the disc.

A. Both approaches attempt to accomplish the same surgical goals. Pain is more significant with open procedures than with endoscopic surgery. Another difference is the length of the scar.

A. Avoid bending, and stooping as much as possible. Limit lifting for the first 6 months. Walking and swimming are the best things you can do for exercise. After 9 - 12 months, you can do almost anything, including snow skiing if you want to.

A. Eating a well rounded diet will take care of your body’s nutritional needs. A special diet or supplements are not required.

A. Scoliosis surgery will not prevent you from conceiving babies, delivering babies, or raising them once they are born.

A. No. Only about 5% of the hardware put in ends up being removed. Spinal implants are placed deep to muscle and skin and cannot usually be felt. It rarely causes pain.

A. A few to several weeks, depending on your age, health, prior medication requirements, and the type of surgery done.

A. Avoid bending, and stooping as much as possible. Limit lifting for the first 6 months. Walking and swimming are the best things you can do for exercise. After 9 - 12 months, you can do almost anything, including snow skiing if you want to.

A. We let patients go back to school as soon as they feel good enough. This may be as soon as 2 to 3 weeks after surgery in some cases.

A. After the instrumentation is placed and the curve is corrected, the anesthetic is lightened enough so that the patient can hear and respond, but cannot remember or feel pain. In that dream like state, we ask the patient to move his or her feet to ensure the spinal cord is still functioning. Once the patient moves, we put them back to deep sleep and finish the surgery.

A. INFUSE causes the same bone to form in spinal fusion as would form from using bone graft. The INFUSE fusion comes with a lot less pain.

A. Definitely. In fact, in some cases the bone infusion is significantly stronger or more robust than autograft fusions.

A. We have used INFUSE since the FDA study in 1998 in more than 300 patients and have not seen any side effects.

A. There have been reports that some patients can develop antibodies to infused or bone morphogenic proteins that are not of the patient's own body; however, no known allergic reactions have been reported to my knowledge.

A. The human gene for the INFUSE bone forming protein is placed into cells which mass produce it. The protein is thoroughly checked for purity and packaged along with the carrier sponges in a sterile container for surgeon use.

A. This is a synthetic protein initially harvested from animals. A polymerase chain reaction is used to manufacture the protein from this initial donor.

A. Surgeons choose to use INFUSE because it forms a solid fusion more reliably than a persons own bone graft, without the pain of the bone graft. With less surgical pain and a more successful surgical outcome, both patient and surgeon are happier. The sponge is incorporated into the new bone that forms.

A. Physicians use infused bone graft because of the potential for a higher fusion rate. There is also no chance of disease transmission as in some allograft donor bones. The sponge that is used for the carrier is also utilized by the protein as a scaffold to help form the new bone that your body develops.

A. Any of the INFUSE bone forming protein that drips off the carrier sponge washes out of the body within a few minutes. Bone only forms where the carrier sponge is placed.

A. Infused or bone morphogenic protein works well in areas where there is blood supply. There also has to be a scaffold for infused bone. Usually a scaffold is a collagen sponge. If there is no scaffold and blood the inner fuse will be washed away and will not cause inner bone to form. In fact, this has been the problem to some degree in what we consider posterolateral spinal fusions. The scaffold can still be a cause in sponge; however, the muscles tend to compress the collagen sponge to the point where no true scaffold is present, and no bone forms in a majority of cases.

A. INFUSE is a manufactured copy of a normal protein present in your body. The protein causes a high concentration of bone forming cells to accumulate wherever it is placed. The protein is placed on a collagen sponge (another normally occurring body protein) to hold it in place. Wherever the sponge is placed, bone will grow.

A. It is a very similar protein to a portion of the group of proteins called bone morphogenic proteins, which were initially isolated in the late 60s.

A. INFUSE causes the same type of bone to grow as would grow with bone graft taken from a person’s own pelvis. In several studies, INFUSE seems to be even more reliable at achieving fusion than a person’s own bone.

A. In some studies infused, especially used anteriorly, has a better fusion rate than autograft; however, the studies on posterior spinal fusion over the transverse processes have not been complete and have not shown a higher rate of fusion than autograft to date.

A. Pain is the major complication from harvesting bone graft. It can last long term in as many as 20% of patients, though we probably do not know the actual percentage.

A. In many patients bone graft harvesting site pain lasts over two years and sometimes is permanent; however, the majority of patients do not have a permanent problem with this, and it usually lasts less than two years.

A. Bone graft site pain is usually centered over the harvest site on the back of the pelvis. It is often perceived to be in a different area (left or right of midline) from surgical pain (usually midline). Some patients cannot distinguish between the two areas of pain and it feels like one large area of pain.

A. Most patients will have pain that is more manifest in the buttock and pelvic areas than in the spinal fusion area, and this is easily identifiable for most patients. The pain also usually subsides quicker from the spinal fusion area rather than the bone graft site.

A. Pain is the major complication from harvesting bone graft. It can last long term in as many as 20% of patients, though we probably do not know the actual percentage.

A. The potential complications for bone graft harvesting include bleeding from vessels in the buttock. Other complications and more common complications include infection in the area. Lastly, fracture can occur secondary to bone graft harvesting.

A. When the pack of the pelvis is thinned to harvest bone graft, pain is the natural result. That pain usually goes away in several weeks. About 20% of patients have some lasting discomfort at the site, whether sporadic or constant. Narcotic pain medication occasionally required.

A. Pain from the bone graft site occurs in every person; however, it is not longstanding in every person. In approximately 30% to 40% of people, they will have longstanding bone graft pain depending on how it is taken. These numbers vary depending on the author who has written the papers.

A. A person’s own bone fragments obtained from decompressing the spinal nerves can be saved and used for graft. Bone can also be used from a bone bank, though this type of bone does not have any live cells capable of creating new bone. A very reliable option is INFUSE, a small sponge with genetically engineered protein that will cause bone to form wherever the sponge is placed.

A. At the present time, bone morphogenic protein can be used in some areas of the country for spinal fusion; however, insurance companies are limiting its use secondary to the expense. Other options include allograft bone, which does not have as high a fusion rate usually. Lastly, synthetic grafts such as beta- tricalcium phosphate with bone marrow aspirate can be used with very similar fusion rates to allograft.