The Many Dangers of Spinal Surgery
Ways for safely treating neck and back pain
In the first part of this series, I discussed how pain management fits perfectly into the medical business model since pain is a chronic condition and a lot of money can be made from partially treating it indefinitely. In turn, a variety of unsafe and ineffective medications are routinely used to treat pain, two of which, the NSAIDs and the opioids are arguably some of the most dangerous drugs on the market. Since the existing treatments frequently fail, patients are often referred for spinal surgery, which are both even more profitable than the other options but also even more dangerous.
Conversely, many effective treatments for chronic pain conditions exist, but they have been mostly kept off the market because there is no money to be made in them. In the case of neck and back pain, I feel the primary issue is that limited knowledge exists regarding what causes pain there. This is important because many of the existing “treatments” for back pain actually worsen the underlying causes of that pain. For example, ligamentous laxity underlies many chronic spinal pain conditions, but one of the primary treatments for spinal pain (injected steroids) directly weakens the affected ligaments, creating a situation where therapies which are good for business but bad for patients frequently end up being chosen.
Note: many other conditions like chronic dizziness are also frequently caused by poorly functioning vertebral ligaments.
Similarly, as discussed in the previous article, spinal degeneration is often due to waves of force not being able to smoothly transfer through the spine, something which becomes much worse once part of the spine becomes surgically fused together and loses its ability to move freely.
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In this article we will explore the many dangers of spinal fusions, the predatory business model that promotes their use, and many of the safe ways my colleagues and I have used for decades to effectively treat neck and back pain. Prior to reading this article, I would highly recommend reading the first part of this series if you have not yet done so you can better place the ideas here into context.
The Business of Spinal Surgeries
In the first part of this series, I discussed how ligaments in the body weakening triggers many issues, including the spinal joints becoming worn down and arthritic, muscles in the back reflexively tightening, and discs bulging and then herniating. Yet, rather than address this, we often “treat” spinal pain by injecting those arthritic joints with a steroid, which temporarily reduces the inflammation there (for weeks to months) but does not address the cause of the inflammation.
In fact, the opposite happens because steroids weaken ligaments—thus creating the situation where more and more of the treatment is needed to provide a diminishing relief—which sadly is quite commonly seen within the predatory business model Western Medicine thrives upon.
In turn, I and many colleagues believe the reason why spinal steroid injections became so popular was not because of the evidence supporting it, but rather because of how much insurance reimburses for them.
Note: spinal epidural steroid injections (particularly for the low back) used to be an incredibly lucrative procedure (and made pain management one of the highest paying medical specialities). Because this incentivized these procedures and so much money ended up being spent on them, insurance providers (e.g., Medicare) reduced the reimbursements, which in turn resulted in more of them being performed by many doctors in order to make up for the revenue that was lost from declining reimbursements.
Tragically, an even worse situation exists with spinal surgeries, which I would argue results from a high degree of ambiguity with when they are justified and them being one of the most profitable areas in medicine.
Much of this was illustrated by an investigation by the Seattle Times I learned about from a patient who knew the family. It started with the story of Talia who had Ehler-Danlos syndrome and was gradually developing complications from her hypermobility.
Note: While EDS responds very well to certain treatments like nutritional supplementation, it is typically mismanaged and worsened by the increasingly invasive treatments it receives.
Talia’s father, a family physician, took her to see Seattle’s celebrity neurosurgeon, Dr. Delashaw (who as you might guess was widely advertised by the hospital). After selling the family on the surgery and the quality of care she would receive, Talia received it in the hopes it could improve her life—and once the surgery was completed, Deleshaw informed there were no complication and it had been perfect. However:
But as the anesthesia faded in Talia’s system, she realized that not everything was perfect, despite the confident assurances of her surgical team.
Her lower jaw was ajar, jutting forward like a bulldog’s. Her face was swollen. Her delicate, singsong voice came out in a harsh rasp. She couldn’t open her mouth enough to squeeze in a finger. On her hospital bed, lying next to the stuffed rhino and stuffed zebra she’d brought along, Talia croaked to the nurse that she was having difficulty breathing.
She rolled onto her side and vomited in the bed. When the nurse covered up the spew with a towel, Talia vomited again right on top of it.
Her father realized this was potentially a huge problem because she might lose the ability to breathe (due to neck swelling) and then require an emergency intubation, but be impossible to intubate because the fusion prevented her neck from moving. He aggressively petitioned the staff to move her into the ICU in case this happened and to have a cricothyrotomy kit available so an emergency hole could be cut into her neck to get air in.
The hospital staff repeatedly dismissed their concerns (even as Talia become more and more unable to breathe), and Dr. Deleshaw did nothing except quickly document that Talia was doing well.
Aapproximately 24 hours after her surgery, Talia’s throat closed and she lost the ability to breath. The ICU staff attempted to intubate her (which was impossible due to her fusion) and ignored Talia’s father’s pleas for an emergency cricothyrotomy (which I presume was ignored since it differed from their standard procedure) and after 20 minutes of impaired breathing, Talia entered cardiac arrest.
About 15 minutes after Talia took her last breath, a new doctor came in the room and assessed the scene. He [at last] called for the crike kit.
None was in the room.
This experience broke Talia’s father and led to him quitting the practice of medicine.
The publicity this case created led to a lengthy investigation of the hospital where it was discovered:
•In 2012, Dr. Deleshaw was hired by UC Irvine in 2011 because the administrators there (as memos showed) believed Delashaw could make them a lot of money and gave him a starting salary of 900,000 plus a commission for the money his surgeries made and those he could incentivize his colleagues to perform.
•Once there, Deleshaw started siphoning money from his colleagues to himself, which understandably upset the other doctors and Deleshaw later justified in testimony by stating:
I wanted all my faculty — as I said to them many times — I want them to be rich… But in order to be rich, you have to work and you have to do clinical volume or you have to have other kinds of financial support.
•At UC Irvine, his colleagues reported him for dozens of cases where Deleshaw had performed, reckless, unjustified, fraudulent (claiming to operate when the operation had not been really performed) and partially botched surgeries. They feared many of these surgeries were clear malpractice cases where a jury would almost certainly side against UC Irvine, and to quote one of his colleagues:
[Deleshaw’s surgical complication rates] are higher than anybody else I’ve ever seen in my life.
•To sustain this volume, Deleshaw would often delegate most of his work to doctor training under him (e.g., he would have three operations he was supposedly performing occur simultaneously or have clinic patients scheduled at the same time one of his “operations” was running). This is important because when he sold those operations to prospective patients, he made them feel like he would take care of the entire case and give a lot of attention to them to ensure they had the best possible outcome from the “amazing neurosurgeon.”
•Many other complaints were also filed against him such as forcing a patient who did not want a surgery to get one, giving questionable testimony in a malpractice case. One of the most noteworthy testimonials I saw against him occurred when the family of a patient he’d just operated on wouldn’t pick the patient up after the surgery (which required Deleshaw to have to spend a bit of time documenting the patient’s stay in the hospital), and Deleshaw forced a resident to call immigration control so the patient (who was not legally in the country) would be picked up by them and then deported—thereby removing the patient from the hospital.
•Despite these complaints UC Irvine did not address them, presumably due to all the money Deleshaw made for the institution and then two years after working at UC Irvine, the Seattle hospital decided to recruit Deleshaw to run their neurosurgery department against the protest of their own surgeons.
•Once hired, Deleshaw delivered and quickly changed the department to one that did far more lucrative surgeries:
•This required triple booking surgeries, doing a variety of more invasive (but more lucrative) surgeries and short staffing the hospital staff who looked after patients once the operation was complete.
For example, when aneurysms are treated, a safer option (accessing the brain through a blood vessels) can often be performed in place of a dangerous one (cutting the skull open to operate) and at both Irvine and Seattle, Deleshaw made the majority of surgeries switch to the more dangerous one (e.g., he increased the rate 5-fold at Irvine), which was followed by the severe complications of those surgeries dramatically increasing (e.g., severe brain bleeds were 9% there vs. 4% at other hospitals in the state, and brain bleeds after the clippings were 14% there vs. 7% for the state).
•Ultimately dozens of his colleagues left the hospital because they felt uncomfortable with the clear risk Deleshaw exposed patients to. Nonetheless, the hospital retained him in his chair position (paying him 2 million dollars in 2014), and when a medical board investigation was later conducted (due to Deleshaw creating a hostile work environment for his colleagues) it ultimately concluded that Deleshaw had done nothing wrong and no sanctions were taken against his license. In 2017 he left Seattle, and then later was hired by Tulane where he now works as a professor of neurosurgery.
Note: Deleshaw also sued the Seattle Times for their investigation of him. Ultimately the one “positive” thing which came out of all of this was the court dismissing his libel lawsuit.
Deleshaw clearly put profits before his patients, to the point such unsustainably high numbers of surgeries were done, even patients like Talia who had a doctor advocating for them throughout their patient stay could not get basic medical care done to protect them from lethal complications of these rushed surgeries.
At the same it’s important to note that while some neurosurgeons followed in Deleshaw’s footsteps, many others did not and prioritized the welfare of their patients over making even more money. However, the key takeaway from this story is not Deleshaw’s conduct, but rather that the administrators in both California and Washington sided with the unethical doctors because they made way more money for the hospital (and likewise changed the physician’s compensation structure to incentivize them performing more of these unsafe surgeries).
This in short is identical to the situation we saw throughout COVID-19—many doctors wanted to do the right thing and save their patient’s lives, but they were sanctioned by the hospital (and often the state) for doing so since it cost the hospital money, whereas the doctors who had many of their COVID-19 patients die because they followed bad protocols faced no consequences for doing so. Similarly, many doctors (including numerous ones I’ve corresponded with in both the USA and Canada) immediately recognized the dangers of the vaccines, but were sanctioned by their hospital for discussing this with patients and thus could not share those concerns.
Note: as detailed in The War on Ivermectin, there were 80 lawsuits where families with a relative being subjected to Fauci’s hospital COVID protocols and was expected to die had lawyer Ralph Lorigo sue the hospital for ivermectin to be administered to their relative. Of those 80 lawsuits, in 40 the judge sided with the family, and in 40 with the hospital. Of the 40 cases where ivermectin was given, 38 of the 40 patients survived. Of the 40 cases where the hospitals were allowed to withhold ivermectin, 2 of the 40 patients survived. This should have been a sign to consider using ivermectin but instead the hospitals banded together to develop a robust legal strategy to prevent any future lawsuits from succeeding. This in my eyes clearly illustrates the degree to which hospitals prioritize profits over patients.
So, I would argue that the incredible amount of money to be made in neurological surgeries means that you cannot just assume they are being done because they are in the best interests of the patients. In turn, the existing evidence shows that patients often do not benefit from spinal surgeries, but since there is a high degree of ambiguity in the value of those surgeries, less-ethical surgeons will frequently perform them on patients who are otherwise not good candidates for them. For example, while Deleshaw worked in Seattle, he dramatically increased the rate of (not medically justifiable) Lumbar fusions that were done.
Note: the existing evidence supporting spinal fusions is much weaker than you would expect (given how frequently they are performed). The existing evidence in turn shows the patients who respond best to spinal surgeries are those who have both pain and clear clinical signs of a nerve impingement. However, in many cases, spinal surgeries are performed in patients without those neurological signs.
The Risks and Benefits of Spinal Surgeries
When considering a spinal surgeries, I’ve found the following to be true:
•Cervical spinal surgeries cause the greatest number of issues for people.
•Thoracic spinal surgeries are the least frequently done (as they are the most difficult to do and the least likely site of a disc bulge or herniation due to the stability created by the rib cage). Normally, these are only done because the patient has an unusual condition (e.g., a damaged bone) which requires a surgical repair.
•Lumbar spinal surgeries, while not perfect, tend to benefit patients more than cervical spinal surgeries.
With surgeries, there are a few different types that are done. Such as:
Repairing a broken bone—these, while less than ideal are necessary and hence their benefits outweigh their risks.
Removing part of the vertebrae which is compressing a nerve (termed a laminectomy)—these tend to offer the greatest benefit to patients. In the lumbar spine they are frequently life changing and have minimal side effects, while in the cervical spine, they often benefit patients but have a greater risk of causing complications.
Note: there are non-surgical ways to perform laminectomies I’ve seen work wonders for patients, but very few people perform them due to the difficulty and potential liability involved.
Inserting foreign hardware into the spine (e.g., a spacer between two vertebrae where the disc is) or attaching multiple vertebrae to a piece of metal (termed a spinal fusion). There are a variety of ways fusions can be done, some of which partially preserve the motion of the spine (and cause less issues) and others which fully fuse a large portion of the spine to immovable rods running along it.
Note: surgeries that remove parts of a herniated disc are also performed. These often are followed by the placement of surgical hardware to stabilize the spine, especially if a significant portion of the spine in removed.
Throughout my career, I have both met people who considered spinal fusions to be life changing for then, but I have also met more people than I can count who had a very bad response to the fusion and would have given anything to have gone back in time and not gotten it.
Some of the major issues with spinal fusions include:
•The spinal fusion does not relieve a patient’s pain and often makes it harder to fix in the long term (e.g., patients with “failed back syndrome” are much harder to treat the pain of later on).
Note: almost all of the chronic back pain patients my colleagues and I have had minimal success with fell into this category.
•Loss of mobility in the spine (which can often be quite significant).
•Over time, the fusions (or the attached vertebrae) will often wear down and fail, which leads to the spinal fusion needing to be redone, or the patient being worse than they started after the fusion has failed. Similarly, vertebraes immediately next to a fusions often will gradually fail.
Note: the spine continually moves and conducts force through it, so if a place can’t move, force disproportionately concentrates there (e.g., the top or bottom of a fusion).
•Defective hardware fails in the patient, or experimental hardware is used without the patient’s consent. This can include defective (but proprietary) screws being used, blood-clot inducing cement being used, and counterfeit hardware being used.
Note: there have been numerous lawsuits over this as since spinal surgeries are a highly lucrative field, many questionable products are pushed onto the market by investors looking to make a quick profit. Similarly, spinal surgeons are often paid off by the hardware manufacturers to use their dubious wares.
•Toxic reactions to the metals used for spinal fusions (termed metallosis). I periodically meet patients who develop significant chronic injuries due to their reactivity to the metals placed in their spine (e.g., sadly I recently heard of a patient who underwent medically assisted suicide because no “expert” knew that their symptoms were a common example of metallosis and thus told the patient the illness was incurable). These reactions are the most common when toxic metals (cobalt, chromium or nickel) are used in the implants.
Note: research has shown that toxic metals from implants frequently corrode and enter the circulation. Additionally, while most physicians are unaware of metallosis, there are hundreds of studies on it and it has been repeatedly shown that metallosis can occur weeks to years after spinal fusions.
•A loss of sensation is created in the body due to a nerve being affected by the fusion. A variety of other much more debilitating conditions (e.g., arachnoiditis can also occur).
Note: metallosis can induce compressions of nerves.
•Significant injuries can occur as complications of the surgeries (e.g., consider Talia’s story). Likewise, many cases (e.g., in the elderly), a high rate of death occurs in the years immediately following the operation.
•There is a significant disruption of the vital energy that runs through the spine.
Note: while this one seems strange, many spiritual teachers I’ve spoken to feel very strongly about the importance of it. One of the best anecdotes I can describe was a vaccine injured patient I worked with who had a cervical fusion (which had to be redone) prior to the vaccine, and after their vaccine reaction, appeared to have developed a loss of neurological function on the left side of their body originating at the site of the fusion. I sent them to a well-known Chinese medicine practitioner who was able to restore their neurologic function and told me that “the Qi was very blocked there, it was hard to open it.”
For each of these reasons, I try to help patients avoid spinal surgeries unless it is very clear they need one and will benefit from it and it cannot be treated in another manner.
Treating Spinal Pain
When working with patients who have spinal pain, I find that most of what can be done with the conventional approaches can be achieved with much less invasive (and significantly more effective approaches.
Typically, I initially try doing some combination of the following:
•Send them to someone who had a good track record in providing permanent improvements through spinal manipulation (and more importantly does not injure people).
Note: in patients with ligamentous laxity or weakened bones, popping techniques can often cause significant issues.
•Have them address their upper-cross syndrome and any other tight muscles that appear to be contributing to the pressure on their spine.
•Do something to decompress the spine if there are any signs a disc in compressing the nerves of the spine.
In the majority of cases, these work (especially if the correct person does them). If they don’t or they only provide temporary relief, I then look at a variety of other less common causes and consider having options for acutely managing their pain.
While there are some nuances on how to do them correctly (e.g., the physical therapy and regenerative approaches for treating disc herniations or ligamentous instability), I find in the majority of cases they work and can avoid the need for surgery. When reading these, try to really think through each before you do them so you either do them correctly or find the correct person to do them with.
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