DOC DAVE,
Ive been tring to read thru the negative feedback on L5-S1 spinal fusions, but there seem to be to many. Stats say 80 some odd percent success, where are they? I to have run the PT gamit, and now my L5-S-1 ddd herniation is irritating my groin(central) nerve roots(ie. poss bladder/bowl shutdown). My Ortho-surgen has performed 30 fusions with only 3 failed. PLEASE, if youve had the same type of "ray-cage" fusion, and your a success, please reply. Thanks Bill from Denver. P.s. I'm also looking for the best Ortho in denver too. THANKS FOR THIS SITE!
Follow Ups:
Re: Doc Dave: L5-S1 DDD spinal "ray-cage" fusion??
Posted by David Ferguson, D.C. on October 21, 1998 at 18:51:17:
In Reply to: Doc Dave: L5-S1 DDD spinal "ray-cage" fusion?? posted by Bill Hallinan on October 21, 1998 at 14:53:32:
I don't have any good news regarding low back surgery. There are instances where it is DEFINETLY needed but the guy who stands to make $30,000+ from it should not be the person who you take ALL the advice from. (Obviously that's why you are here)
The whole ball of wax, when it comes down to success, depends on what you call "success". For some Dr.s they call success as anyone who didn't die on the table. For others it's pain levels at 6 months, 12 months, 1 year, etc. As for your ortho saying his success rate is 3/30 failed, well, how much time are we talking here? Is there a 1,3,5 year follow up on all these patients with an Oswestry pain scale evaluation?
The best I have seen on any study was a 50/50 chance of feeling any better. The rest I have seen were 1/3 better, 1/3 the same, and 1/3 worse.
Another drawback is the muscle damage. "Back muscle injury occurs in all patients who underwent posterior lumbar surgery,..."(Spine 1996;21:941-944)
With MRI studies of non symtomatic patients showing the existence of disc buldges in 30-70%(depending on the study) of the general population, there is NO guarantee that the diagnosis is 100% correct and thus no guarantee that the surgery will have ANY effect.
There is also evidence that the fusion itself will lead to pain and ligament degradation.
"The altered biomechanical
environment produced by spinal fixation, surgical intervention itself, or
nonphysiologic mobilization can affect the ligamentous
properties in vivo, possibly serving as the impetus for low back pain." (Spine 1998 Mar 15;23(6):672-682
The effects of spinal fixation and destabilization on the biomechanical and
histologic properties of spinal ligaments. An in vivo study.)
"Complications were recorded in 18% of fusion patients"
The same amount of people (18%) underwent a reoperation within 5 years!
(Spine 1998 Apr 1;23(7):814-820 5-year reoperation rates after different types of lumbar spine surgery.)
"Nobody in America should be allowed to have back surgery unless they have
seen a Chiropractor first"
Robert Mendelsohn, M.D.
Former Chairman of the Medical Licensing Committee for the state of
Illinois, Associate Professor of Preventive medicine and Community Health in
the School of Medicine of the University of Illinois and the recipient of
numerous awards for excellence in medicine and medical instruction.
Dr. Mendelsohn stated, "My feeling is that somewhere around ninety percent
of surgery is a waste of time, energy, money and life." His conclusions in
this matter are supported by the recent publication of the Government
Guidelines by the Agency for Health Care Policy and Research (AHCPR), a
division of the U.S. Department of Health and Human Services, and by the
Independent Health Research Group, who say the number of unneccessary
operations total more than three million.
"...for the management of low-back pain, chiropractic care is the most
effective treatment, and it should be fully integrated
into the government's health care system."
The Manga Report, 1993.
"Chiropractic treatment was more effective than hospital outpatient
management, mainly for patients with chronic or severe
back pain."
British Medical Journal, 1990.
British Medical Research Council Study.
"Two and three years after patients with back pain were treated by
chiropractors, they experienced far less pain than
those who were treated by medical doctors."
British Medical Journal, 1990.
"A majority of family physicians (in Washington) admitted having
encouraged patients to see a chiropractor, and
two-thirds indicated a desire to learn more about what chiropractors do."
The Journal of Family Practice, 1992.
"Our trial showed that chiropractic is a very effective treatment, more
effective than conventional hospital outpatient
treatment for low-back pain ... particularly in patients ...
Follow Ups:
Re: Doc Dave: L5-S1 DDD spinal "ray-cage" fusion??
Posted by Walt Stoll on October 22, 1998 at 11:48:55:
In Reply to: Re: Doc Dave: L5-S1 DDD spinal "ray-cage" fusion?? posted by David Ferguson, D.C. on October 21, 1998 at 18:51:17:
Thanks, Doc Dave!
I knew you could bail me out here!
Namaste` to you, Walt