I think that everyone understands that the info presented here is good for what it's worth... stuff posted on the internet. Some items are absolute nuggets of gold, and some are harmful misinformation. It's up to the reader to look at the information available and take what good they can... and hopefully contribute in a manner that will benefit the community. That's the internet at it's best. I credit the braintalk forum with saving my life... had I not found them I would have had a 2-level BAK fusion with no posterior instrumentation. Because of the info I discovered there, I came to understand that I was responsible for learning what I could to make informed decisions about my care.
This is a great discussion and I'm glad we are having it because it's a microcosm of what we face as patients... go to 5 doctors and get 8 different opinions. All are experts... how do we decide? Unfortunately, too many of us are naive about the situation and often are on the wrong side of failed spine surgery before we understand that we need to take responsibility for our care, be good consumers and make informed decisions. We grew up in a world in which we... get sick... go to the doctor... do what he says... and we expect to get better.
I've seen too many people who are abandoned by their health care providers and told that they have no options other than chronic pain and disability... only to discover that they do have options. Some will try those options and fail, but many will also succeed. However, when we are empowered to ask the right questions and seek the right information... WE get to make the decisions. WE get to take the risk.
To some people, this will sound like doctor shopping and recognize that in some situations, patients are looking for a doctor that will tell them what they want to hear... and that may be the worst possible scenario... going until you find a doctor who is willing to do something that all the other doctors know is out of bounds. In other cases it results in finding a doctor willing to take on the difficult cases who actually knows that the patient who looks out of bounds stands a reasonable chance of success. If the patient is successful, the doctor is a genius. If not, the doctor doesn't look so hot. Look at the flute players case...
www.fluteguy.com and on the
GPN story page (BradleyL). He's more than 2 years out now, having a normal life. (Unfortunately, the trip to Miami made it so I couldn't attend the release party for his new CD. He's doing great.) His case was way out of bounds and he went to many doctors and got many opinions. All were against the surgery that was ultimately performed... except one. The point is that the PATIENT gets to decide. They get to take the risks. They have to live with the results.
Get multiple opinions. Don't take anything at face value. Find a way to separate the marketing spin and competing interests from the information that is really relevant to your decision. In many cases, this is an impossible task. Even though it's overwhelming and we may ultimately have to make a decision realizing that certain knowledge of the best course is not something we can achieve... we still have to try... because we take the risk... we have to live with the results. We also must understand that even if we do have certain knowledge of the best course to take... we still may fail.
Some rules are there to protect the patients from surgeons of less than average ability, yet they keep others from getting the best care from better surgeons. Some rules are there to protect the manufacturer from liability. It's a shame that spine surgery isn't automatic and that there is so much that is poorly understood, but it is. Do your homework... make informed decisions.
Mark