Dr. Timothy Peppers

As is becoming usual, I first met with his nurse (RA) who went through the usual questionnaire. Then Dr. Peppers arrived. I was impressed by his demeanor although he was younger than I anticipated. He put up some of my images and began to talk about my back. He prefaced his comments by saying that low back pain is difficult to diagnose and treat. Sometimes they don't get the best results even when everything seems to "line up." However, he did say that I appeared to line up to be very treatable.

Based on my previous tests and imagery, Peppers thinks my pain is discogenic. He did say that the facet joint on the left side looked pretty bad with a noticeable bone spur. The question is whether or not that is contributing to my pain. If it were, then sitting should decrease my pain whereas moving would aggravate the symptoms; but my situation is the opposite.

We discussed fusion vs. disc replacement. He said the post-recovery functionality and pain relief is very similar although he did mention the potential strain on the next level from a fusion. In 10-20 years, what will happen to the L3/L4 disc from the increased strain? I asked about the artificial disc longevity, and he said they are subject to much less wear and tear than a knee or hip replacement, so they should be OK. They've been using replacement discs in Europe since 1987 (Dr. David study?), and they are holding up well so far. He said that he himself had a fusion in his neck, but if he had the option now he would have done a disc replacement, which is quite a testimony in my book.

According to Peppers, I am a good candidate for a two-level replacement. He recommends the Pro-Disc. He has done approximately 200 of the procedures since October 2001. He checked my insurance and sort of shook his head saying that Blue Cross is problematic and won't approve it. He said insurance companies approving disc replacement are Aetna and Cigna. I had a sudden, stinging realization that I may have been better off staying with Kaiser where Dr. Green probably could have performed the procedure. I felt my face suddenly flush red with anger, sadness, and frustration. It's been a rough couple of weeks for other reasons (Hayley), and I almost started crying right there in the room but held myself together. Asked him about out-of-pocket expenses without insurance coverage, and he gave me a ballpark guesstimate of $40,000 for a 2-level replacement including a 3-night stay at the adjoining Scripps Hospital.

I thanked him sincerely but told him I was leaning towards Delamarter. Peppers seemed unperturbed and said Delamarter was a good guy.


appointment to discuss options including disc replacement

Timothy A. Peppers, MD
CORE Orthopaedic Medical Center
332 Santa Fe Dr Ste 110
Encinitas CA 92024
Phone: (760) 943-6700 or (760) 632-4269

Medical Assistant = Brenda (or Victoria?)

info on Dr. Peppers from Scripps