Special to the Nugget
There is a crisis in spine care. Costly, dangerous procedures, today touted as the next magic solution, are tomorrow shown to have low effectiveness, or worse, to pose a threat to the systemic health of the patient.
And yes, YODA can help. Not the big-eared, short-statured wiseman-creature we know from Star Wars. This Yoda is the Yale Open Data Access initiative, which is an attempt to allow a look behind the scene of medical research on drugs and devices.
YODA resulted from the use of Bone Morphogenic Protein (BMP), a genetically derived ‘bone-product’ used to improve bone repair at spinal fusion sites.
This product was originally intended for limited use on very ill patients with poor bone healing. Instead, it has been widely used over the last decade, in one-quarter of all fusion cases. Eighty-five percent of the time, its use was “off-label”, meaning it was used for conditions it was not approved for.
BMPs use increases the cost of fusion surgeries by $15,000 or more. This on top of the fact that spinal fusion is “one of the more lucrative procedures in medicine”, according to Shannon Brownlee, author of “Over-treated: Why Too Much Medicine is Making Us Sicker and Poorer”).
The initial application to the FDA for approval of BMP listed the side-effects patients are now experiencing, such as back and leg pain, inflammation, cancer, sterility and retrograde ejaculation.
Thirteen later studies of close to 800 people suspiciously showed no complications whatsoever. “That there were no adverse effects should have raised some eyebrows”, Eugene Carragee, MD a spine researcher, said.
It turns out the company producing BMP, Medtronics, had influenced the research. Each research paper written cost Medtronics 12 to 15 million dollars and each study had at least one researcher on Medtronic’s payroll.
Medtronic is to be commended, now, for releasing all research data. Hopefully YODA will help restore honesty to our “science” so it can again be trusted.
However, the entire thrust of this column is to shine light on how un-scientific most of our health care approaches are.
Science is first and foremost observation, and recognizes the fact that an organism has adapted to a certain lifestyle over millennia (e.g., sun exposure, contact with the earth, regular physical activity throughout the day with limited sitting, and of course no TV or processed food!). To make the radical changes to natural life patterns modern man has done, is to court disaster.
So, in the meantime, the same sage advice used in business works also in the “business of healthcare”: Buyer Beware.
Or, as the real Yoda might say, “Wary must the buyer be.”
Dr. Huntington practices Chiropractic, Biomedical Acupuncture and Physiotherapy in Oracle, Az. 520-896-9844 firstname.lastname@example.org.