If you were sitting in your doctor’s office, suffering from back or knee pain, and your doctor recommended surgery, would you agree? What if you knew that clinical trials had labelled the recommended surgery as basically useless?
That’s the question posed in a fascinating article we read this week on the website of the New York Times. It’s called “Why ‘Useless’ Surgery is Still Popular,” and we encourage you to click here to read it. Even if this dilemma doesn’t apply directly to you today, chances are you have a loved one or a friend who is facing the decision about whether or not to go ahead with recommended surgery. As the Times article suggests, getting definitive data to help you make the right surgical decision isn’t always easy.
The New York Times article starts by pointing out the contrast between drugs and surgery. When it comes to drugs, the Food and Drug Administration requires rigorous testing to prove that your prescription is safe and effective. Not so, however, with surgery, which is basically unregulated by the FDA. What happens, asks the Times, when a surgery is essentially shown to be useless, specifically when it fails one or more clinical trials? As a patient, unless you’re willing to do a great deal of homework, you may have no way of finding out.
In the article, the New York Times writer focuses on two common types of spinal surgery and one commonly-performed knee surgery. In each case, trials proved that the surgeries were no more effective that alternative, not-surgical regimens for alleviating pain. Yet all three of these procedures are still commonly performed, at least until the past few years when insurance companies have started reining in their reimbursement rates.
The first operation cited by the Times is spinal fusion. This procedure, which “welds together” adjacent vertebrae to alleviate pain, has been evaluated in not one but four clinical trials, all performed in the early 2000’s. What did these trials conclude? According to the article, “Surgery was no better than alternative nonsurgical treatments, like supervised exercise and therapy to help patients deal with their fear of back pain. In both groups, the pain usually diminished or went away.” The article goes on to report that spinal fusion surgery rates only started to decline when many insurance companies announced they would no longer cover it.
The second spinal procedure mentioned by the Times involves injecting a kind of cement into the spine to strengthen and stabilize it. These operations, known as “vertebroplasty” and “Kyphoplasty,” have also had their effectiveness called into question. The prestigious New England Journal of Medicine published a damning article comparing vertebroplasty to “a sham procedure.” Yet these procedures continue to be performed.
The final surgical procedure mentioned by the New York Times, and one that surprised us, was surgery for a torn meniscus, part of the natural “shock absorber” in the knee. About 400,000 adults in the U.S. have surgery each year to repair a torn meniscus, says the Times – but the outcomes have been shown to be very uneven, with many patients continuing to experience pain. That may be due a surprising finding: when orthopedists performed MRI scans on adults with no knee pain, they often found meniscus tears. These doctors concluded that the diagnosis of a torn meniscus may have little to do with the cause of pain, leading to a high incidence of unnecessary surgery.
One of the reasons we here at AgingOptions want to bring this to your attention is that we want you to enjoy the best possible health for the longest possible time. That’s one important way for you to avoid ever becoming an unnecessary burden on your loved ones. For this reason we strongly urge our senior clients to seek medical advice from a geriatrician, someone who specializes in the unique health care needs of seniors. If you’ll contact our office we can provide you with referrals to geriatric physicians in your area. Having a doctor who really understands you and your needs can help you avoid unneeded surgery, with all the cost and frustration that can bring with it.
Just as in the medical arena, you need sound advice in all the other aspects of your retirement planning: financial plans, legal affairs, family communication and housing choices. We will help you blend all these facets of retirement into a plan we call a LifePlan – your blueprint for the safe, secure, rewarding retirement you’ve worked for all your life. Find out more by taking a few hours to attend a free, no-obligation LifePlanning Seminar. You’ll find it time very well spent! For dates, times and registration, click on the Upcoming Events tab – or call our office. It will be our pleasure to serve you.
(originally reported at www.nytimes.com)