Medtronic is a medical device company which produced BMP-2 (bone morphogenetic protein-2) for use in lumbar spinal fusions. The thought was when a patient needs a single level anterior approach fusion of the lumbar spine, the surgeon can use a cage filled with BMP-2 to stimulate bone growth (fusion). This would eliminate the need to gather bone from the hip which can be painful and leads to a secondary surgical site. In a laboratory, BMP-2 performed wonderfully and bone grew extremely well.
However, as many patients unfortunately found out, this was too good to be true. Up to 85% of the surgeries involving BMP-2 in 2007 (which is over 85,000 surgeries) were done by using the compound off-label. Surgeons began using it in the cervical spine and with both anterior and posterior fusions. In some cases, bone grew so fast that patients began suffering blocked airways and an inability to swallow as bone literally grew out of control from the cervical spine.
Perhaps the most damning part of this is that the US Senate Committee of Finance determined that Medtronic executives secretly drafted favorable journal articles when BMP-2 was found to perform no better than traditional bone grafting techniques.
Circumstances like this undermine public confidence, produce harm, and in some cases permanently impact a patients quality of life. A patient going for surgery is placing full trust in a surgeon; and when that trust is intentionally broken the patient deserves full compensation while the doctor deserves the most severe penalties available by law.
As chiropractors, we must consistently promote the use of conservative care. Many patients who do not fully exhaust conservative care options end up going to have surgical intervention. Perhaps they went for a few physical therapy visits or maybe even had an injection. Barring red flags, progressive neurological deficits, or an emergency situation; patients should be encouraged to fully explore all conservative measures prior to surgery.
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