“There’s a lot of gray zone decision-making in spine surgery,” DiGiorgio said. “You could show a patient presentation, an MRI, to five spine surgeons and get 10 different answers.”
Dr. Randall Dryer, an orthopedic surgeon at Central Texas Spine Institute who treated White but did not perform her surgery, said doctors often have to make a convincing case to insurance companies.
“The insurance companies refuse to accept the fact that surgery for degenerative disease is effective. They will say it’s because the medical literature doesn’t support it, but they take cherry-picked articles that support their case, and they tend to downplay other literature that would indicate that surgical treatment is effective,” Dryer said.
An Aetna spokesperson pointed NBC News to two published analyses that found no clear benefits from spine surgery over a nonsurgical intervention. But other studies have shown that spine surgery is superior to nonsurgical treatments, such as physical therapy or injections, and reduces a patient’s disability.
White’s father, Wrath James White, is the policyholder for her insurance plan. He said he was shocked to receive a letter from Aetna saying their request for coverage had been denied.
“I had never had insurance reject a legitimate claim before, and my daughter’s pain seemed about as legitimate as you can get,” he said.
When his daughter was diagnosed, the family tried less invasive approaches than surgery such as physical therapy, steroid injections and anti-inflammatory pills. But it became clear to them — and to White’s doctors — that spine surgery was the only option to alleviate her pain.
“I did everything I possibly could for four years to avoid doing surgery on her,” Dryer said. He noted in a 2022 report that White was “miserable” and “I could significantly improve the patient’s condition with a simple decompression and discectomy,” referring to surgical procedures to remove compression on her nerves.
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A report from White’s surgeon in April said she had “failed multiple rounds of physical therapy and pain management and as such I feel she has reached a point for surgical intervention.”
White’s parents ultimately decided to set up a GoFundMe to raise money for the surgery. In a matter of days, they received more than $33,000 in donations — close to the amount they were quoted for White’s surgery, including hospital fees, anesthesiology and doctor’s fees.
Wrath James White said he believes a lot of those donations were “small and silent protests.”
