Insurance Denies Life-Changing Scoliosis Surgery

A growing number of surgeons are reporting that insurance companies are slow to update their policies regarding a novel scoliosis surgery. This delay impacts patients like Vivian Hukriede, whose family is suing Aetna for denying coverage for her vertebral body tethering (VBT) procedure. The surgery, which uses a flexible tether to correct spinal curves in growing adolescents, is FDA-approved but still deemed experimental by some insurers.

The Hukriede family faced multiple denials from Aetna, which cited a lack of long-term efficacy data and higher complication rates compared to traditional spinal fusion. However, surgeons advocate for VBT, highlighting its advantage in preserving spinal motion and potentially avoiding future complications associated with rigid fusion rods. While VBT has risks, including a potential need for revision surgery, proponents argue its benefits are increasingly clear.

This coverage dispute reflects a broader pattern where medical innovations face resistance from insurance providers. Surgeons performing VBT often spend significant time challenging claim denials, arguing that established medical societies recommend coverage for this procedure. The family's lawsuit seeks to compel Aetna to approve the surgery, which is crucial during Vivian's peak growth years.