What do surgeons say about disc replacement?

While reading this morning about the first spinal disc transplant, I was reminded of the excitement over the artificial disc a while ago. It was a big deal! It was revolutionary! The Seattle Times did a big piece on a woman who was miraculously cured, etc. etc.

I was skeptical, partly because it made sense to be and partly because………hey, I was born that way. About this time I talked to a local neurosurgeon and asked him about it. He didn’t think it was very effective. But, people will want it….”so I’ve got to offer it.”

More recently I was at a continuing education meeting with a group of mostly local spine surgeons. The presenter gave a clinical vignette (i.e. a made up patient case, describing a patient with intense, persistent back pain). He then asked how many, by a show of hands, would opt to get a disc replacement surgery if THEY WERE THE PATIENT. Not one hand went up. 50-75 spine surgeons in the room and not one would subject themselves to a disc replacement!

Do unto others as………..?

Back Pain, Lies and Videotape

I was watching a TV show, or movie the other night. One of the characters tried to help someone out and got sued for injuring her. The good guys got smart, videotaped the “injured” person and the law suit was dropped.

This makes for great fantasy. The good guys win and the case is clear cut. However, in real life, it doesn’t work like this.

We cannot see back pain. We can take x-rays, MRI’s, CAT scans, bone scans and more. On these images we see potential problems. It’s not like a broken bone, or cancer. It is not anywhere near that straightforward.

In cases with litigation this can cause some….discord, or skepticism and heated debate at least. Defense lawyers – both the evil, scheming and the others – think that they might get some insight on the case by following the patient with a video camera.

I was at a conference awhile ago. A lawyer showed some video of an “injured” patient. This guy was climbing fences, running around. He actually, by himself, hoisted a full size couch into the back of a truck which had sides higher than his head!

Not all cases of video surveillance are clear cut. Some could be argued legitimately either way….not this one. Well, what do you think the judge said after he saw the tape………c’mon guess.

This is actually a trick question. The judge refused to look at the tape! Apparently, according to this defense attorney, this is common. Judges don’t like the invasion of privacy caused by the video surveillance.

Truth is stranger than fiction.

Scoliosis: Be Afraid…Be Very Afraid!

On a regular basis, patients come into my office with big worries about their scoliosis. The thing is, most of these patients DON’T HAVE SCOLIOSIS….never had it, never will. But, someone, either at school or some doctor (often, I am ashamed to say, a chiropractor) has told them falsely that they have a scoliosis.

As a result, they carry these visions of future pain and disability around for years. Sometimes they even avoid activities they love because they think it will be bad for their scoliosis.

Here is an example of a mild case of scoliosis. He has probably had this curve for decades. I would guess that his curve is about 20 degrees. Looking at his back, you can see he has a curve. But if you didn’t know to look for it, would you notice it? Probably not.

Even with this long-standing scoliosis, he does not have much disk disease. Looking on his x-ray (it is a little hard to read on the computer at this size), I don’t see any more degeneration than I would expect in someone who has gray hair.

He is doing well. Most of the patients who come into my office have a curve that is half the size of this curve and usually more like 1/4 or 1/8. They have no more reason to worry about their backs than anybody else – at least not related to the curve.

So, what about people with a real scoliosis – as big as the picture or more?…………I’ll put that in another post.

Chiropractic in the Hospital?

Norwegian researchers reporting on the inclusion of chiropractors in the hospital orthopedic system concluded:

 

Based on our experience, we believe that the inclusion of chiropractors within hospital orthopedic departments is feasible and provides a patient care resource that may benefit not only the patients but also the department as a whole.

To give credit, I first saw this on The CAM Report. The article can be found here.

LA Times article on the wonders of back surgery

Read the article (click here).