Total Joint Replacement Common Questions

If you’ve just started exploring the BalancedBack™ Total Joint Replacement as an alternative to spinal fusion for leg and back pain, you probably have a few questions. To help you with your research, we asked our team to answer the most common ones. If you don’t find the information you’re looking for, we encourage you to schedule a free clinical call or download one of our brochures.


Why do I have to travel for surgery?

Every country has its own regulatory paradigm. Due to the pace of the Food and Drug Administration (FDA)’s approval process, anti-innovation efforts to control skyrocketing healthcare costs, and a politicized insurance system, the U.S. is often slow to adopt new medical technology.  

In contrast, the British territory of the Cayman Islands provides a first-class healthcare, financial, and tourism economy efficiently regulated by the Health Practice Commission (HPC). Each of our U.S.-based, fellowship-trained providers is licensed by HPC to practice in Cayman, as well as the U.S. The team travels with you to Cayman for surgery, where HPC regulates the safe clinical use of BalancedBack™. This arrangement gives you the opportunity to take advantage of the advanced technology ahead of a possible approval by the FDA.  

Destination healthcare is an emerging trend. More and more people are taking control of their own healthcare, seeking safe, effective, and affordable solutions to their medical conditions outside of the United States system.

How much does the BalancedBack™ procedure cost?

Typical total cost is approximately $55,000 USD, including travel, surgical care, and door-to-door ground concierge service.

Does insurance cover a total joint replacement?

The BalancedBack™ procedure is not covered by insurance. Certain self-insured plans may provide for reimbursement, but the procedure is private pay.

What is the recovery period?

Recovery from any surgical procedure will depend on your individual condition. A member of our surgical team will discuss their expectations with you prior to surgery. In general, BalancedBack™ patients are ambulating the day of surgery and are discharged from the hospital at day three. Patients spend an average of five days recovering on Seven Mile Beach before traveling home, with daily physician visits and rehabilitation sessions. Most patients begin a more aggressive physical therapy program at week six, and return to unrestricted activity at three months.

How long will I be in the Caymans?

Patients typically arrive in Grand Cayman Tuesday or Wednesday, two or three days ahead of their scheduled procedure, and travel home the following Thursday or Friday. The length of stay can be shortened or extended based on your individual condition and preference, but 10 days total is typical. Please note that pricing is not influenced by length of stay. It is our goal to design the optimal destination healthcare experience based on your travel distance, time off work, travel preferences, and individual condition.

What is the experience like?

We work hard to provide the highest-quality care from the time you arrive on the island until you’re safely back home. It all starts with understanding your individual condition and determining if BalancedBack™ is right for you. If the answer is yes, our team will customize travel arrangements to make your trip easy. We select routes, flights, and seats based upon our experience. When you land in Cayman, our ground concierge will meet you at the airplane, guide you through immigration, and take you to your hotel on Seven Mile Beach, managing your luggage along the way. A team member will meet you at the hotel and remain available to help with small requests throughout your stay, like groceries, dinner reservations, or other needs. You will complete one last pre-operative visit at NovoClinic prior to your surgery that includes pain and disability scores, baseline pre-operative x-rays, and a neurologic exam. Our team will manage transport to and from CTMH (Chrissie Tomlinson Memorial Hospital) Doctors Hospital for you and your traveling companions during your surgery stay. Our goal is to get you out of the hospital and back to your room on Seven Mile Beach as quickly as possible, where our clinicians and rehab specialists will visit you several times daily to aid with your mobility and minimize any post-surgical discomfort.

A safe surgery is our number-one goal, but we also take pride in a superior vacation experience in the days before and following your surgery. We believe the postoperative experience is important for your long-term recovery, and have structured the entire program to maximize your chances of a successful outcome.

On the day of departure, our ground concierge will meet you at the hotel, manage your luggage, and bring you to the airport, expediting you through security and staying with you until you are comfortably seated on the airplane. From there, the airline will assist you with connections and luggage to your local ground transportation home. (For your comfort, we request special assistance from the airline on departure.)  

Even after you arrive home, you’ll interact with a dedicated NovoClinic team member to coordinate future care through your primary care physician, physical therapist, or other providers as needed. Our goal is to help you regain full, pain-free motion, and the outcome you expect.

Can I make my own travel arrangements?

We prefer to arrange travel, simply because we know what is easy and hard for people with your healthcare condition. If you are a savvy traveler and prefer to make your own arrangements, let us know and we’ll tailor a program to meet your needs. People often ask to use airline miles or other loyalty programs to reduce travel cost, which is fine, or elect private air travel over commercial flights in certain circumstances. Whatever your request, we have likely managed it before and will be happy to help meet your needs.

Can I bring someone, and will it increase the cost?

We strongly encourage you to bring a friend, spouse, or significant other. It makes the experience more pleasant for you, and it’s a good opportunity for both of you to enjoy the beauty of the Cayman Islands. We pass through any incremental expenses at cost, working hard to minimize expenses. For one traveling companion, there is generally little to no impact to your total cost.  

When patients come to Cayman a day or two early with someone they trust, we see the natural anxiety of traveling for care melt away. Snorkeling, swimming with the turtles, or just relaxing on the beach for a day can be very positive. This extra time also lets you get to know our team better, so when you need something later, you’ll feel like you’re asking a friend.

How would I know if this procedure is right for me?

Our clinical coordinator will do an initial screening, with a few basic questions about your history and condition. A BalancedBack™ surgeon will then review the data and request additional imaging, usually an MRI. Thereafter, you will discuss your condition and the procedure with your surgeon, and make a decision together if BalancedBack™ is right for you. We also welcome involvement from your current spine surgeon, primary care physician, therapist, or chiropractor.

Who are the BalancedBack™ surgeons?

Dr. Scott Hodges and Dr. Craig Humphreys perform BalancedBack™ procedures at CTMH in Grand Cayman, assisted by anesthesiologist Dr. Nathan Schatzman and their team. All our fellowship-trained, Board-certified specialists have 20+ years of clinical practice in the United States. Please visit our website to read their biographies. You can also visit Heathgrades or similar websites for more information.

How can I get a BalancedBack™ surgeon to review my condition?

Either visit the Learn More section of our website, or email our clinical staff directly. They’ll help you gather the information you need about the BalancedBack™ procedure, and facilitate an evaluation by one of our surgeons. If you’re a good match for the procedure, it may be possible to schedule surgery in just a few weeks, depending on availability. In other cases, patients interface with our team for many months prior to care, try conservative therapies, or even travel to Cayman to tour the facilities before scheduling a procedure. Our goal is to provide whatever level of information you need. We do not charge for any consultations.

Haven’t found the answer you’re looking for?

Contact us here. It’s important to us that every patient considering Total Joint Replacement surgery understands their condition, the alternatives, and how BalancedBack™ can help. If you are not a candidate for BalancedBack™ we will help you determine the right course of action. 

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