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Christopher v. Joseph T. Hardy & Sons, IAB No.: 1318548 (Dec. 9, 2013).

The Industrial Accident Board denied Claimant's Petition to Determine Additional Compensation Due and concluded that a proposed lumbar fusion surgery was not reasonable and necessary.

Claimant sustained a compensable lumbar spine injury on October 29, 2007. Claimant’s course of post-injury medical care included selective nerve root blocks, lumbar epidural injections and a L2-3 laminotomy and microdiscectomy (and subsequent repair surgery). This medical treatment was not contested.

However, Claimant continued to experience ongoing lumbar symptomology, including pain and left lower extremity numbness. Claimant’s physician was concerned about continuing L2-3 pathology and recommended a surgical consultation. Diagnostic testing revealed chronic L3 radiculopathy and retrolisthesis. The neurosurgical consultation concluded that an L2-3 fusion would be appropriate and indicated, given Claimant’s ongoing pain complaints.

Employer contested that surgery was medically indicated and contended that the surgery would not be beneficial to the claimant. Employer’s medical expert pointed to Claimant’s complications from the two prior procedures and testified that there was significant risk of additional scar tissue which could increase the possibility of nerve damage. Further, Employer’s expert testified that the L2-3 level was not unstable and that the claimant demonstrated good physical function.

Ultimately, the Board determined that the surgery was not reasonable in this case. The Board focused on the prior poor surgical outcomes and pointed to the Claimant’s general physical condition and concluded that the current symptomology was not debilitating. The Board also acknowledged that some of Claimant’s complaints were clearly unrelated to the L2-3 level and was particularly concerned about the risk of harm to Claimant’s adjacent levels, should the proposed surgery have been performed. As a result of these concerns, the Board denied Claimant’s petition.

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