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I suppose this is as good a place as any to post a few extracts from this paper that came out in last month's Spine Journal. It may help explain the reason for some of the skepticism we are expressing to Maxene.
Clinical Research
Is the Spine Field a Mine Field?
SPINE Volume 34, Number 5, pp 423–430
Many interventions are performed for axial back pain associated with common degenerative conditions, sometimes with weak or absent evidence of efficacy: so-called “dynamic stabilization” with various implants, distraction with interspinous devices, corticosteroid injection into the facet joints, prolotherapy, intradiscal steroid injection, botulinum toxin injection, intradiscal electrothermal therapy, radiofrequency facet denervation, radiofrequency sacroiliac denervation, and intrathecal therapy with opioids, to name a few. Though thousands of patients have been treated with these methods, there is no evidence of high-grade efficacy for even one of them.
At the same time, highly publicized news stories of surgeons receiving “millions in consulting fees, royalties and research grants” have appeared, in the context of “sham consulting agreements, sham royalty agreements, and lavish trips to desirable locations.”12 A large device manufacturer has paid a fine to the government to settle such allegations. 13 As a result, the spine field has been subject to ugly characterization in the press, highly skeptical governmental investigations, and frank accusations of corruption. Consumer Reports recently listed spinal surgery as number 1 on its list of overused tests and treatments.14 This is clearly not where this field wants to be.
A recent commentary in JAMA labeled the current system of industry-sponsored clinical research as “broken” and suggested that clinicians can no longer rely on the medical literature for valid and reliable information.47
(That last paragraph is especially for Sharon)
Granted that this paper/essay is focusing on spine surgery, I don’t think the conservative (ie bracing, Schroth, etc) treatments deserve to escape the same scrutiny; indeed I would suspect the situation there is worse. (As an aside, I wonder if they are referring to VBS when they say “dyanamic stabilization” in the first paragraph - hope not.)
I don’t think Maxene is a shill/plant, I think she is someone excited about the results she is seeing and wants to share the news with others. At the same time, and please don’t take offence Maxene, it sounds a bit like you “drank the cool aid”. I interpret the statements from the manufacturer as a warning to folks to stay away from practitioners offering correction and vestibular rehabilitation. You read the same statements as being ‘conservative’ and destined to change soon. (They did change soon, I’m pretty sure they were just put up there recently).
I agree the last thing you need is us telling you here that you are going to fail. That is not helpful. But there is a fine line between rooting for your success and reining in the influence of your enthusiasm on others who stumble across the posts (about the potential for a curve correction in an adult spine).
Let me just leave you with this encouraging thought. My opinion only. I would not rule out the possibility that the folks you are seeing could teach the inventors a thing or two about their brace. There is something to be said for experience and it sounds like they have treated a lot of people, maybe more than the folks in Montreal. The person who invented the paint brush doesn’t necessarily lay claim to being the best painter.
Clinical Research
Is the Spine Field a Mine Field?
SPINE Volume 34, Number 5, pp 423–430
Many interventions are performed for axial back pain associated with common degenerative conditions, sometimes with weak or absent evidence of efficacy: so-called “dynamic stabilization” with various implants, distraction with interspinous devices, corticosteroid injection into the facet joints, prolotherapy, intradiscal steroid injection, botulinum toxin injection, intradiscal electrothermal therapy, radiofrequency facet denervation, radiofrequency sacroiliac denervation, and intrathecal therapy with opioids, to name a few. Though thousands of patients have been treated with these methods, there is no evidence of high-grade efficacy for even one of them.
At the same time, highly publicized news stories of surgeons receiving “millions in consulting fees, royalties and research grants” have appeared, in the context of “sham consulting agreements, sham royalty agreements, and lavish trips to desirable locations.”12 A large device manufacturer has paid a fine to the government to settle such allegations. 13 As a result, the spine field has been subject to ugly characterization in the press, highly skeptical governmental investigations, and frank accusations of corruption. Consumer Reports recently listed spinal surgery as number 1 on its list of overused tests and treatments.14 This is clearly not where this field wants to be.
A recent commentary in JAMA labeled the current system of industry-sponsored clinical research as “broken” and suggested that clinicians can no longer rely on the medical literature for valid and reliable information.47
(That last paragraph is especially for Sharon)
Granted that this paper/essay is focusing on spine surgery, I don’t think the conservative (ie bracing, Schroth, etc) treatments deserve to escape the same scrutiny; indeed I would suspect the situation there is worse. (As an aside, I wonder if they are referring to VBS when they say “dyanamic stabilization” in the first paragraph - hope not.)
I don’t think Maxene is a shill/plant, I think she is someone excited about the results she is seeing and wants to share the news with others. At the same time, and please don’t take offence Maxene, it sounds a bit like you “drank the cool aid”. I interpret the statements from the manufacturer as a warning to folks to stay away from practitioners offering correction and vestibular rehabilitation. You read the same statements as being ‘conservative’ and destined to change soon. (They did change soon, I’m pretty sure they were just put up there recently).
I agree the last thing you need is us telling you here that you are going to fail. That is not helpful. But there is a fine line between rooting for your success and reining in the influence of your enthusiasm on others who stumble across the posts (about the potential for a curve correction in an adult spine).
Let me just leave you with this encouraging thought. My opinion only. I would not rule out the possibility that the folks you are seeing could teach the inventors a thing or two about their brace. There is something to be said for experience and it sounds like they have treated a lot of people, maybe more than the folks in Montreal. The person who invented the paint brush doesn’t necessarily lay claim to being the best painter.
)
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