ARTIFICIAL
SPINAL DISK MAY OPEN NEW ERA
IN MAKING BACK PAIN WORSE!
Robert Filice, M.D. Former staff physician
The
11-02-2004 edition of The Wall Street Journal ran an article on
Johnson and Johnson’s newly approved artificial spinal disk.
Once an adequate number of surgeons is trained (it is a very
technically difficult operation) the procedure will be offered
as the new alternative to fusion operations in the treatment of
degenerative disc disease. The manufacturer’s hope is that many
chronic back pain sufferers who have been holding off on having
surgery will now commit to this new procedure. Aside from the
technical risks which involve an abdominal incision and the
temporary exterior displacement of all the contents of the
abdominal cavity, the surgery also offers all the well known
risks of general anesthesia, possible damage to nerves in the
operative field, local or systemic infection, and inadequate
pain relief because of inappropriate misapplication of the
procedure. I believe that of all the risks enumerated, this last
one is the gravest.
When new
technology arrives in this country, as long as it involves a
drug or a surgical procedure, it is widely and enthusiastically
promoted in the national media. This naturally creates
excitement among those affected by the condition in question. In
this case, the millions of people with chronic
low back pain
will now be going to their doctor and asking whether this
procedure might help them. The danger lies in the fact that the
operation will be applied over-liberally for pain conditions in
which it is unlikely to help. This will subject many individuals
to the risks (including death) of the procedure without giving
them a reasonable chance of success. The history of orthopedic
surgery is full of procedures that were inappropriately applied
for the wrong conditions. Strain of the spinal
ligaments,
sacroiliac strain, and
iliolumbar ligament strain are a few of
the common conditions that cause chronic back pain that may be
misdiagnosed as arising from degenerated disks showing up on
MRI.
Individuals with
chronic pain mistakenly thought to be arising
from the degenerative disks will inappropriately be subjected to
the risks of this surgery, and will not benefit at all. Any kind
of surgery is unlikely to help patients with chronic
degenerative disc disease. Since the process is systemic, and
other spinal segments are also usually affected, how is spinal
disk replacement supposed to “change the natural history of the
disease” as one physician supporter so enthusiastically is
quoted a saying in the Journal article? Add to that the fact the
X-ray and
MRI findings often fail to correlate with the
patient’s pain, and you have a recipe for disaster.
My point is
to warn my readers that there’s a new phenomenon out there in
the orthopedic world…spinal disk replacement. The mentality is
exactly the same as
hip and knee replacement surgeries: ie,
don’t do anything about the cause, wait for the condition to get
unbearable, and then replace the “broken” part. This may work
for cars, but I can assure you it is a bad approach for the
human body. Remember that orthopedists rarely examine lower
backs in such a way as to reproduce the patient’s pain. As a
result, they rely excessively and inappropriately on scans and
X-rays, and therefore make a lot of mistakes in diagnosis and
treatment. If the mistaken treatment is innocuous, nothing is
lost. But when the offered treatment is risky, like surgery, a
lot of innocent people may get hurt. What to do? In any chronic
musculoskeletal condition, but especially in chronic low back
case, see a
Prolotherapist before agreeing to any tests or
invasive procedures (including surgery,
epidurals, and
steroid injections).
Prolotherapy favorably mobilizes the body’s own healing
mechanisms, and with proper diagnosis successfully addresses
back pain at its source, and without surgery.