Spinal Fusion Statistics

[Pooka1]

Really? Are there randomly controlled studies? ;-)

Are there randomly controlled studies on whether or not to set broken arm bones?

I wager NOT! Yet we still have the great run of ER surgeons doing just that!!!



But seriously folks...

That pro/con article is a joke. For the same reason some legitimate scientists don't debate young earth creationists (there can be no debate between science and religious dogma), I don't think legitimate orthopedic surgeons should debate those pushing crackpot, counterfactual positions either.

[rtremb]

As far as I know none of us are doctors. The article is written by doctors therefore one might be wise to read the information they are providing with an open mind...only fools rush in...

[JulieBW]

old fusions

I will chime in on the question of aging fusions. Mine was done over 40 years ago. I have some degeneration at the base of my fusion, but the problms are ones I can live with, do not warrant revision. My surgeons (Godfrey/Weiss) were doing fusion surgery at the rate of one per week when mine was done. I have never seen anyone here who had these surgeons. People who post here are mostly the ones with problems. The flatback issue casued many problems, I am fortunate mine is thoracic. I believe there are many people aout there with no significant problems.

[Snoopy]

I will chime in on the question of aging fusions. Mine was done over 40 years ago. I have some degeneration at the base of my fusion, but the problms are ones I can live with, do not warrant revision. My surgeons (Godfrey/Weiss) were doing fusion surgery at the rate of one per week when mine was done. I have never seen anyone here who had these surgeons. People who post here are mostly the ones with problems. The flatback issue casued many problems, I am fortunate mine is thoracic. I believe there are many people aout there with no significant problems.

Julie,

You are absolutely right. A lot of people on this forum come here because they are having problems and are looking for advice.

Mary Lou

[Pooka1]

As far as I know none of us are doctors. The article is written by doctors therefore one might be wise to read the information they are providing with an open mind...only fools rush in...

You wait around long enough not "rushing in" and you can find every crackpot out there.

If you think posting a citation from 1941 in 2008 is intellectually honest then I can't help you. You need more work with skeptical thinking and just being way more familiar with the issues here than you seem to be. You have to have a minimum baseline from which to tell the wheat from the chaff that appears to be missing in many of your posts. Even basic stuff like thinking VBS wasn't experimental three years ago when it is STILL AS I TYPE experimental surgery. This is very basic, Ruth.

[Pooka1]

Some examples of piss-poor writing/editing

from the pro/con surgery article posted in this thread...

The 1941 reference:

"The early belief was that spinal fusion could be used to leave the patient with a mild residual deformity but this is not the case as one third of patients lost all postoperative correction within one to ten years post surgery [54]."

54. Shands AR, Barr JS, Colonna PC, Noall L. End-result study of the treatment of idiopathic scoliosis. Report of the Research Committee of the American Orthopedic Association. J Bone Joint Surg (Am). 1941;23:963–99741.

Note there are at least two problems with this. The "con" surgery folks are talking about what was the early belief (in their opinion... not necessarily the case) and then instead of saying "this WAS not the case: they say "this IS not the case" falsely implying that the outcome achieved prior to 1941 applies to today, now.

Note also the pagination. With just these two problems in this one short passage and reference, I am guessing this article was NOT edited by peers or anyone.

Ruth, some doctors are crackpots. Some doctors write papers of questionable intellectual honesty. Some doctors lose their license. Some doctors design braces that they are trying to sell.

Doctors are not perfect and make mistakes.

In these cases, you don't have to be a doctor to figure out which way the wind is blowing.

[txmarinemom]

As far as I know none of us are doctors. The article is written by doctors therefore one might be wise to read the information they are providing with an open mind...only fools rush in...

Ruth,

Sharon's got a point about the skeptical evaluation of information, and the simple fact someone's a doctor guarantee their slant on a topic is anything more than a poorly veiled to further a vested interest.

Of *course* the people with Schroth want to discourage surgery ... it's in their favor to do so and get more people in their program. It's unfortunate they used complete falsehoods to further that goal (and wrote such a biased paper some people obviously think is legitimate), but what do you expect?

Just because a paper exists doesn't mean it's true and accurate.

Out of curiousity, how would you justify:

"Health-related signs and symptoms of idiopathic scoliosis cannot be changed by surgery."

and

" ... the indication for spinal fusion surgery is for cosmetic reasons, only. "?

Do you believe either one of those assertions are correct? If so, please explain why.

It doesn't take an M.D. to interpret either statement, and the utter inaccuracy of both makes the entire paper - and motives of the authors - suspect. And "only fools rush in" to what *exactly*, Ruth? Ignoring an inaccurate paper, or believing it just because a doctor authored it?

Regards,
Pam

[Pooka1]

Ruth,

Sharon's got a point about the skeptical evaluation of information, and the simple fact someone's a doctor guarantee their slant on a topic is anything more than a poorly veiled to further a vested interest.

The lack of appropriate skepticism is arguably responsible for all the couterfactual nonsense that runs through society today besides quack medicine including ESP, tarot cards, ghosts, goblins, devils, demons, young-earth creationism, world-wide flooding, fate, etc. etc. etc.

Of *course* the people with Schroth want to discourage surgery ... it's in their favor to do so and get more people in their program. It's unfortunate they used complete falsehoods to further that goal (and wrote such a biased paper some people obviously think is legitimate), but what do you expect?

Desperate, ignorant people are looking for answers. The subset of these people who are irrationally afraid of surgery are going to seek out quack and lay sources that are riddled with ignorance, errors and lies because it reinforces their belief that they already hold with respect to surgery.

It is no different than the folks who tout the counterfactual young-earth creationism sites. They already believe it so they refuse to bring the appropriate skepticism to the table. A cursory review of the actual science easily refutes all this counterfactual stuff. It's a lack of intellectual honesty. A crisis even.

[rtremb]

How can anyone be so sure that surgery is the right thing to do? It is somewhat offensive to suggest that a person should not investigate all possible treatments for scoliosis. Just because it is European doesn't mean it isn't good for some people. Did anyone ever think about how much money it costs for spinal fusion surgery and how much money the doctors who do this surgery are making? -- probably way more than the Shroth doctors/staff.

I don't know why you are attacking me Sharon. You do not know if you know more about this subject than I do so I would take it kindly if you would stop attempting to insult me. Respectfully I thank you in advance for your consideration of my feelings and respecting the fact that you do not know me therefore you would be wise to not assume how much reading I have done or have not done on this subject.

Ruth

[Pooka1]

How can anyone be so sure that surgery is the right thing to do?

Using EVIDENCE. Just like for everything else in your life when the rubber hits the road. It is really no different, Ruth. But you have to be able to understand what you are reading. You have posted two articles, one in a lay magazine and one is an apparently non-peer-reviewed journal that are both riddled with counterfactual information. Ask yourself if you could pick out which statements are counterfactual and why.

Anything less than evidence is worthless.

There is evidence about which curves should be fused when.

There is evidence about which curves should not be fused ever.

There is skepticism borne of a lack of evidence. This is what drives science forward and gets real answers to real problems. It's also what weeds out quackery and paranormal nonsense from reality.

There is also skepticism borne of ignorance and fear. I have never found this to be helpful. Just my experience.

Good luck.

[PLR]

Thank you to all who have responded - I truly appreciate it.

I'll keep searching for studies as I outlined. I'd love to base our decisions on cold, hard, well-documented, vigorously-researched facts taken over a long period of time. But I realize that crystal clear guidance isn't always available.

I agree that the skill of one's surgeon is extremely important; our surgeon is well-respected and performs lots of fusions. So I feel OK there.

Our son's scoliosis is not currently causing pain or other problems. His curvature is noticeable, but only if you know what to look for. He is very athletic. Given that he has several more years of growing to do, we'd love to be able to avoid surgery as long as we can. Forever, hopefully.

I found several papers by Dr. Weiss. He seems to be one of the few anti-surgery voices. I wonder if he'll be able to convince the medical community...

[Pooka1]

I found several papers by Dr. Weiss. He seems to be one of the few anti-surgery voices. I wonder if he'll be able to convince the medical community...

He'd convince virtually everyone in the medical community if he would actually pony up some non-anecdotal, REPEATABLE evidence for his claims. In ~90 years, nobody has ponied up evidence for Schroth. We know this independently because nobody has been awarded the Nobel in medicine for devising a method to avoid fusion surgery.

In the meantime, he publishes "look at the wookie" type articles attacking other (proven!) treatment modalities or review articles, NEITHER OF WHICH constitutes one iota of proof FOR Schroth.

A consultant for Quackwatch has weighed in on Weiss and Schroth. The thread is called "Quackwatch and Schroth" or "Schroth and Quackwatch" if you are interested.

Good luck.

[Pooka1]

I earlier answered just your first question because it was the most important BY FAR. Here are some more thoughts...

It is somewhat offensive to suggest that a person should not investigate all possible treatments for scoliosis.

Why waste time investigating long-standing "treatments" with no evidence in the form of controlled studies?

Just because it is European doesn't mean it isn't good for some people.

I have no idea what you are driving at here. Europeans hold many Nobels.

Did anyone ever think about how much money it costs for spinal fusion surgery and how much money the doctors who do this surgery are making? -- probably way more than the Shroth doctors/staff.

Did you ever stop to realize that there is a damn good reason why posterior spinal fusion is considered the "gold standard" treatment? Also, have you considered WHY insurance companies kick out all that money, sometimes a quarter of a million dollars, for these fusions? Do you think Weiss is correct that this is only cosmetic? Someone needs to send a telegram to the insurance companies to stop paying for all this cosmetic surgery!

Only evidence for efficacy, like fusion sugery has shown, would justify a single dime going to Weiss/Schroth... evidence that Schroth has had ~90 years to produce. The world is still waiting.

I don't know why you are attacking me Sharon. You do not know if you know more about this subject than I do so I would take it kindly if you would stop attempting to insult me. Respectfully I thank you in advance for your consideration of my feelings and respecting the fact that you do not know me therefore you would be wise to not assume how much reading I have done or have not done on this subject.

Ruth, I am not trying to attack you. Everyone is entitled to their own own opinions. They are not entitled to their own facts. Agreed? For example, You don't get to unilaterally declare that VBS was not experimental three years ago. Okay?

[rtremb]

Sharon:

You are mis-understanding me. You are correct about one thing -- I have an absolute fear of (and distaste) for spinal fusion surgery for my dear daughter. It is the thing we want least of all for her and we will only have it done if her life is in danger if she doesn't have it done. That is our family's decision - our choice. Please don't give me your opinion about our decision - it will not change our position.

Shroth began in Europe before spinal fusion was available. It has helped thousands of people to cope with their scoliosis and avoid spinal fusion surgery. I consider discouraging people on this forum from investigating this treatment method is really unfair and shows a bias in favour of spinal fusion surgery.

This is just my opinion. I am entitled to it. Please respect that.

Ruth

[Pooka1]

Sharon:

Shroth began in Europe before spinal fusion was available. It has helped thousands of people to cope with their scoliosis and avoid spinal fusion surgery.

Is this an opinion or a fact?

Facts require evidence.