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Spinal Fusions under Fire

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Interesting article out this week in the Wall Street Journal about the lack of efficacy of spinal fusions and the significant royalty payments made to some surgeons for implanting a certain company’s hardware. In addition, this past month, Blue Cross Blue Shield of North Carolina has stated that it will no longer pay for fusion for low back pain. Like many physicians offering regenerative medicine solutions for the spine, we’ve never been big fans of spinal fusions, with many studies showing high complication rates and a frequent need to fuse the level above or below the fusion, due to overload of these segments. Having said that, for some patients (like the one I saw this morning), with true instability, a fusion can be a good, but imperfect, solution. Rather than fusion, we’re usually able to use other tools like platelet rich plasma injections under ultrasound or fluoroscopic guidance to tighten ligaments to prevent excessive motion. We’ve published on this ability to tighten ligaments in the neck using only injections. We also use Regenexx-PL injections to help decrease nerve pain and hopefully to increase blood flow around the nerve. In addition, Regenexx-C has helped many patients avoid low back disc surgery.

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