image by: Walter E. Dandy Neurosurgical Society

HWN Suggests

Why ‘Useless’ Surgery Is Still Popular

Before a drug can be marketed, it has to go through rigorous testing to show it is safe and effective. Surgery, though, is different. The Food and Drug Administration does not regulate surgical procedures. So what happens when an operation is subjected to and fails the ultimate test — a clinical trial in which patients are randomly assigned to have it or not?

The expectation is that medical practice will change if an operation turns out not to help. If only. It looks as if the onus is on patients to ask what evidence, if any, shows that surgery is better than other options.

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Previously Featured

6 phony surgeries that take placebo to the extreme

But in studies testing surgical procedures, getting a placebo can mean going under the knife. So-called sham surgeries are a kind of extreme placebo, where patients undergo all the rituals and scars of a surgical procedure except for the part meant to help.

Common Knee Surgery Does Very Little for Some, Study Suggests

“Those who do research have been gradually showing that this popular operation is not of very much value,” said Dr. David Felson, a professor of medicine and epidemiology at Boston University. This study “provides information beautifully about whether the surgery that the orthopedist thinks he or she is doing is accomplishing anything. I think often the answer is no.”

Doctors Sound an Alarm Over Leg-Stent Surgery

Now that unnecessary heart-stent procedures happen significantly less often, doctors are flagging a new area of concern: unnecessary leg stents. Some physicians are stenting leg arteries and removing plaque at alarming rates, these doctors say. The often-avoidable procedures could put patients at risk of complications and worsening disease.

How Fake Surgery Exposes Useless Treatments

It can reveal whether popular operations are actually effective.

Many operations could be unnecessary, says leading surgeon

Certain types of elective surgery only benefit patients because of placebo effect, says Prof Andy Carr.

Surgery May Not Be The Answer To An Aching Back

Too many complex back surgeries are being done and people are suffering as a result, according to a study in the current issue of the Journal of the American Medical Association. The general tendency noted in the study — that many patients and doctors think more medical care is always better — has implications for the new health overhaul law.

Why American doctors keep doing expensive procedures that don’t work

The proportion of medical procedures unsupported by evidence may be nearly half.

Why do surgeons continue to perform unnecessary surgery?

This responsibility is not negotiable. The onus is on us.

Resources

3 orthopaedic surgeries that might be doing patients (and their pockets) more harm than good

Our research has shown that people with back pain who seek a second opinion can avoid unnecessary spine surgery, including spinal fusion. And avoid Dr Google. Information on the internet usually oversells the benefits and downplays the harms of common surgeries such as spinal fusion, shoulder arthroscopy, and surgery for a torn ACL (ligament in the knee). You will find misleading information even on websites from trustworthy sources such as government and university websites.