Frequently Asked Questions
Medical
  1. Why are Non-Traumatic spine procedures at the Back Institute better for me than surgical options at other facilities?

  2. Why is Back Institute Surgery Center of Beverly Hills the best and safest surgery center to have my procedure performed at?

  3. What are the risks of your Non-Traumatic procedures?

  4. What type of anesthesia is used for Lumbar Non-Traumatic procedures?

  5. Can spinal stenosis or foraminal stenosis be treated?

  6. How many spine procedures will I require to solve my back or neck pain?

  7. Am I a candidate for a Non-Traumatic spine procedure if I have already had an open operation that didn't work?

  8. Are there any medications that I should avoid before having a Non-Traumatic Discectomy at the Back Institute?

  9. Can I drive after a procedure? When?

  10. I have a protruding or herniated disc. Can it be removed?
General

  1. How do I determine if I am a candidate for a Non-Traumatic Discectomy at the Back Institute?

  2. How long will I have to stay in Los Angeles if I am coming from out of town?

  3. What will my limitations be after having a Non-Traumatic Discectomy and will I have to miss any work?

  4. What arrangements do I need to make to have a procedure at the Back Institute?

  5. Why don't more surgeons around the country perform Non-Traumatic Discectomies?

  6. May I request a specific surgeon?

  7. What is the best way to learn about my treatment options if I think I have a herniated disc?

  8. What causes a herniated disc?

  9. What should I do first to relieve the pain and symptoms of my herniated disc?

  10. Is it possible to have a herniated disc and not have the symptoms?

  11. If I already have hardware in my back, will it affect my surgery?

  12. How long is the rehabilitation period?

  13. What is the difference between a bulge and herniation?
Insurance

  1. What are the costs of a Non-Traumatic Discectomy?

  2. Why isn't the Back Institute in contract with any insurance providers?

  3. Why isn't the Back Institute in contract with Medicare?

  4. Will I be able to know how much my insurance company will pay prior to my procedure?

  5. Does worker's comp pay for procedures at the Back Institute

  6. Are the Back Institute procedures experimental or investigational?

  7. My insurance company approved my evaluation. What should I do next?

  8. I only want my MRI reviewed by the Back Institute? What do I do?

  9. My worker's comp adjuster wants more information, what should I do?

  10. Does my worker's comp doctor need to refer me to the Back Institute?

Why are Non-Traumatic spine procedures at the Back Institute better for me than surgical options at other facilities?
At the Back Institute, we perform the most advanced non traumatic procedures available with the most technologically advanced surgery tools and equipment. Some of our technology is only available at the Back Institute. With a Non-Traumatic Discectomy at the Back Institute, there is no cutting, no bleeding and no scarring. Patients are left with only a dot opening that is covered with a band aid. Our surgery center has the highest level of certification. From all aspects of surgery, the Back Institute is the safest and most advanced center for Non-Traumatic Surgery anywhere in the world.

Back institute is a prestigious institution at the highest level, and in fact ahead of the other top institutions (Ivy League, etc.) in the field of spinal non-traumatic access for disc disorders, which is why many doctors from these other top institutions have come to us for their own spine procedures!! The fundamental approaches for non-traumatic access spinal disc removal were invented here. Since 1986, we have developed a lengthy resume of peer reviewed publications (more than 40 in the non-traumatic access field) and have taught our advanced techniques around the world.

The fundamental approaches of non-traumatic access spinal disc removal procedures were invented here. We have developed a lengthy resume of peer reviewed publications and have taught our advanced techniques around the world.

Why is Back Institute Surgery Center of Beverly Hills the best and safest surgery center to have my procedure performed at?
Our surgery center has the highest level of certification available. From all aspects, the Back Institute is the safest and most advanced center for Spine Procedures anywhere in the world. All of the equipment is specific to Non-Traumatic spine care and doing more procedures in the least traumatic way possible.

What are the risks of your Non-Traumatic procedures?
Complications are almost non existent at the Back Institute. Higher risk operations, such as laminotomy, foraminotomy, MED, and microdiscectomy are done around the country at other facilities. The description "minimally invasive" that centers are using has lost its significance. These so called minimally invasive procedures are actually very invasive because surgeons are cutting muscle and removing bone to get to the disc. They are just doing it through a smaller opening, so they call it minimally invasive. At the Back Institute, we do Non-Traumatic procedures, where there is no muscle cut, no bone removed, and no stitches.

What type of anesthesia is used for Lumbar Non-Traumatic procedures?
Patients are given IV sedation and a local anesthetic. Conscious sedation and a local anesthetic are the ideal and safest way to anesthetize a patient for a Non-Traumatic Discectomy. Patients are very comfortable and are able to become fully conscious very quickly after the procedure

Can spinal stenosis or foraminal stenosis be treated?
The procedures done at our center can treat these conditions removing impingements to the spinal or foraminal canal and freeing the nerve. Pain and symptoms will be relieved.

How many spine procedures will I require to solve my back or neck pain?
One procedure is usually sufficient to treat a patient's spine problems. However, some patients need treatment at multiple levels and this can also usually be treated during the same operation. Very rarely a patient needs to return for a second surgery. There are rare cases where patients re-injure themselves and need to return for another procedure.

Am I a candidate for a Non-Traumatic spine procedure if I have already had an open operation that didn't work?
Yes, many spine problems can still be corrected following a failed surgery or can be redone using a non-traumatic method. Sometimes patients injure discs at different levels than what was treated in a previous operation. Non-Traumatic spine procedures will not create more instability in the spine and will not create more scar tissue, unlike an open revision surgery.

Are there any medications that I should avoid before having a Non-Traumatic Discectomy at the Back Institute?
Patients should avoid any type of blood thinning medication whether over the counter or prescribed.

If a patient is taking a prescribed medication, such as Coumadin, please consult your doctor before discontinuing its use as a medication prior to surgery. If you are taking any other medications, please inform us at the time you schedule your procedure so we can instruct you on a case by case basis whether to continue them or not.

Can I drive after surgery? When?
Patients cannot drive immediately after a procedure. However, 24 hours after coming out of conscious sedation will be a safe time to start driving again.

I have a protruding or herniated disc. Can it be treated?
Yes. The main purpose for doing a procedure is to remove the offending disc material while not causing trauma to the surrounding tissues. Some centers feel that cutting the bone and freeing up some space around the problem is enough. Our position is that there is no need to dissect and traumatize the surrounding tissues instead of treating the disc herniation/protrusion itself.

How do I determine if I am a candidate for a Non-Traumatic Discectomy at the Back Institute?
Potential patients can contact us by phone or by filling out the online patient form on our web site. A patient advocate will answer any questions. Patients can fax in their written MRI reports for a free review by one of our medical staff. Back Institute medical staff will determine if you are a candidate for a Non-Traumatic Discectomy or another procedure. Back Institute offers a comprehensive analysis of the spine and our center treats all spine problems. We treat spinal conditions with the best procedure done in the least invasive way possible anywhere in the world

How long will I have to stay in Los Angeles if I am coming from out of town?
3 nights in Los Angeles is the typical stay for patients from out of town. We have a 2 day program in some cases as well. Patients do not need to stay overnight in the surgery center since the procedure is outpatient, however patients will get to enjoy 3 nights in a nearby Los Angeles or Beverly Hills Hotel.

What will my limitations be after having a Non-Traumatic Discectomy and will I have to miss any work?
Patients begin with passive therapy after the procedure (massage, ice, heat). After 2 weeks patients move on to pool therapy, and then at 4 weeks, patients begin active physical therapy. Most patients can return to work a couple of days after having the procedure. If a patient's job is strenuous, then we recommend waiting 6 weeks or starting with light restricted duties such as desk work.

What arrangements do I need to make before having my procedure at the Back Institute?
Due to sedation, patients cannot drive themselves after a procedure. Patients need to bring all medications they are currently taking.

Why don't more surgeons around the country perform Non-Traumatic Discectomies?
The advancements in proprietary equipment and totally non-traumatic techniques that the Back Institute has made over the last 20 years make us the leader in performing Non-Traumatic Spine Procedures. Many surgeons around the country, even in the biggest centers, claim to do minimally invasive spine surgery when the fact is they are just beginning to learn how to do it. The problem is that the words "minimally invasive" have lost their meaning from over 20 years ago when the Back Institute pioneered the techniques. Today, surgeons around the country are using smaller openings in their procedures, but they are missing the point to "minimally invasive," which is not to cut muscle, not to cut and remove bone, not to cause scarring, and not to alter the normal anatomy of the spine to get to the problem disc area. Spine centers around the country rely on clever marketing and catchy words like "laser" to attract patients, but they are missing the experience, expertise, credentials and technology to do a Non-Traumatic Procedure. In fact laser is rarely needed in any of these procedures, whether done at the Back Institute or elsewhere. Back Institute is the only center in the world that can accomplish these truly Non-Traumatic techniques, and that is why our procedure is a "Non-Traumatic Discectomy."

What is the best way to learn about my treatment options if I think I have a herniated disc?
An MRI is the best way to tell what is going on in the spine. Your local doctor can prescribe one for you. You can then fax in the written report and mail the actual films or CD to the Back Institute for a free evaluation.

What causes a herniated disc?
There are many things that can cause herniations including falling, having an accident, aging, and working.

What should I do first to relieve the pain and symptoms of my herniated disc?
Many patients first try physical therapy, injections, pain management, or chiropractic care to relieve pain and symptoms. Sometimes these treatments may relieve pain temporarily, however they cannot cure a herniated disc. A Non-Traumatic Discectomy is the next safest option for treating a herniated disc.

Is it possible to have a herniated disc and not have the symptoms?
Yes, occasionally people have a herniation and don't realize it. Symptoms can include pain, numbness, tingling or weakness.

If I already have hardware in my back, will it affect my procedure?
We will have to review your MRI results in order to determine this. Sometimes the hardware can be removed and sometimes we will be working at a different disc level, so the impact will be minimal.

How long is the rehabilitation period?
Patients walk out of the surgery center the same day and some fly back home the next day after their procedure. Many return to work within a couple of days. Desk work or non-impact work is required for 6 weeks. Physical therapy also lasts 6 weeks.

What is the difference between a bulge and herniation?
A bulge is when the interior part of the disc becomes irritated and begins to push on the outer wall of the disc. This can cause the wall to bulge and possibly put pressure on the spinal cord or the nerves exiting the spinal cord
A herniation is a more extreme bulge, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out. This tear in the disc ring can put pressure on the spinal cord or the nerves exiting the spinal cord.

What are the costs of a Non-Traumatic Discectomy?
The Back Institute is not contracted with any insurance companies, however we can bill your insurance for you if you have out of network benefits. We will verify what type of insurance a patient has ahead of time and inform you of how much your financial responsibility will be.

Why isn't the Back Institute in contract with any insurance providers?
We like to be straight up with our patients from the start. Our patients will know their financial situation with the Back Institute before they have their procedure. We don't want our patients to be surprised a large balance bill that insurance contracts sometimes require.

Is the Back Institute in contract with Medicare?
Unfortunately, Back Institute's Non-Traumatic Discectomies cannot be covered at Medicare rates

Will I be able to know how much my insurance company will pay prior to my procedure?
The Back Institute is not able verify an exact amount of what your particular insurance company and plan will pay for a procedure

Does worker's comp pay for procedures at the Back Institute?
Unfortunately, worker's compensation insurance will pay state fee schedule rates only and Back Institute's Non-Traumatic Discectomies cannot be covered at those rates. In some states, reasonable payments can be acquired from worker's comp and Back Institute will accept these payments. Payments have to be predetermined or pre-negotiated in order for us to accept worker's comp.

Are the Back Institute procedures experimental or investigational?
No, a Non-Traumatic Discectomy is not experimental or investigational.

My insurance company approved my evaluation. What should I do next?
Please fax the signed authorization letter and predetermination of payment to 310-659-8869 and a representative will call you to schedule the evaluation

I only want my MRI reviewed by the Back Institute? What do I do?
Please send a copy of your films or CD to our office and a patient coordinator will be in contact with you.

My worker's comp adjuster wants more information, what should I do?
Please call the office at 310-551-0690. Please have your adjusters name and phone number and your name and claim number.

Does my worker's comp doctor need to refer me to the Back Institute?
Yes, this is a requirement of worker's comp.

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