Tuesday, 22 January 2013
"..no link between back pain and discs"
Nearly twenty years ago international researchers agreed that spine surgery should not be considered until there had been initially a trial of conservative care but, for the most part, this advice has been ignored.
Ironically, the original two spine surgeons who promulgated the abnormal disc theory, WJ Mixter, MD, and JS Barr, MD, from the Massachusetts General Hospital, also recommended conservative care before surgery.
The paradigm shift away from the abnormal disc theory in spine diagnosis began in 1990 when research by Scott Boden, MD,found no clear correlation between disc abnormalities and back pain.
Richard Deyo, MD, MPH, noted this misleading disc theory has led to “false positive” misdiagnosis, suggesting that “many of these abnormalities are trivial, harmless, and irrelevant, so they have been recently dubbed incidentalomas,” and “they are likely to lead to more tests, patient anxiety, and perhaps even unnecessary surgery.”
Both the North American Spine Society and American Society of Spine Radiology now admit the term ‘bulging disc’ should only be used as a descriptive term, not a diagnostic term. In 2011, North Carolina Blue Cross/Blue Shield announced it will no longer pay for spine fusion if the sole criterion is an abnormal disc.
('conservative care' means non surgical care, such as gentle chiropractic and soft tissue work)