I am sorry for the delay in responding, it’s been a busy week.
You are quite right Amybt, the ‘traditional surgery’ phrase was wrongly attributed to you. I was replying to 3 similar treads at once and became mixed up, I am very sorry and I apologise unreservedly!!
I am also very sorry, for being unable to explain myself better in general.
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What I was trying say about the differing health systems was this, because the American health service is largely run on the grounds of private and free market principles, backed up with public money to support it of course, truly MISS Surgeons in America ‘feel more able’ to open up new clinics and invest in new equipment and training. In turn, this investment leads to more research and diversity within the American MISS health industry itself. This means that there is more choice for American patients and more competition for American medical practitioners who insist on using the ‘standard or traditional’ spinal surgeries.
These standard Surgeons can then do one of two things, either they carry on operating using the same old procedures in the same old way, which is known to have a highly destructive impact on the body and which ‘so far’ has little to no clinical evidence to support it’s use, ‘or’ they can start ‘adapting’ and ‘improving’ these basic procedures in order to minimise the negative and destructive effects for the patients. These Doctors will be the one’s that I described as ‘caring’ for their patients futures. I would assert again, that I believe that these Surgeons are few and far between, but because of the American Free market approach, the pressures on American ‘traditional’ Surgeons to adapt and improve is substantial, unlike the in UK, because if their patients do not improve as quickly or as well as the more caring Surgeons do, they endanger 'their own livelihoods' as patients will avoid them and ‘freely choose’ the more caring Surgeons.
Because of Britain’s NHS system there is nowhere near enough pressure brought to bare on NHS Consultant Spinal Surgeons to make them adapt and improve their procedures to ensure a better post op outcome for their patients. Don’t get me wrong, there are good Spinal Surgeons in the UK, using the ‘Standard or Traditional’ procedures ‘who are’ making a positive impact on their patients lives, as Fitbird said, but this is because these ‘rare’ Surgeons are going the ‘extra mile’ to ensure this positive outcome and a better future for their patients.
The internal political pressures within the NHS ‘not to rock the gravy boat’ and to ‘maintain the status quo’ must not be underestimated!
Microdiscectomy, ‘or’ reduction of disc bulges, is one of these improved procedures. Surgeons using this procedure only usually cut up to a 3 inch initial incision, which is better than old traditional ‘open back’ surgery, which could be up to 6 inches in length. But what is rarely told to patients, is that even though it will be 3 inches in length, they use tools (retractors) to widen this 3 inches by spreading the surrounding nerves, tissue, muscles and tendons so that the actual size of the hole they are working through, could as large as 6 inches in diameter!
This ‘spreading action’ can cause severe and long term crushing injuries, tearing damage, and morbidity in patients who often experience ‘as much’ post op pain as those who are treated by traditional Surgeons using ‘open back’ procedures.
By the by, the 'Micro' in the name does not mean there is anything small about this procedure, it is an ‘open back’ procedure, it actually refers to the 'exterior use' of a ‘microscope’ used to look ‘into’ the back during the procedure!
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Thank you for your link to Dr. Myles D. Brager Amy. I have researched his background and I am sorry to have to report that he cannot, in my opinion, in any way, be regarded as an MISS or cutting edge Spinal Surgeon!
He has been described as being a competent, friendly and an informative Surgeon and is listed as being highly regarded by his patients on his ‘non procedural’ skills in 3 Surgeon selection web sites:
www. healthgrades.com/physician/dr-myles-brager-y4wcv
www.ratemds.com/doctor-ratings/5028/Dr-Myles-Brager-Westminster- MD.html
www.vitals.com/doctors/Dr_Myles_Brager
However, he has also been reported as being in the top 50% (by procedural volume) of US Spinal Surgeons listed who carry out destructive ‘fusion device insertion’ and ‘spinal canal exploration’ and he is also reported as being in the top 25% (by procedural volume) of listed US Surgeons, who regularly perform the equally destructive ‘fusions’ and ‘disc removals’.
Fusion ‘or’ as I prefer to call it, turning 2 mobile vertebrae in to 1 solid immobile bone, was never originally developed as a spinal treatment, it was a ‘last ditch’ attempt to prevent the life threatening effects of muscle spasms on TB sufferers in the early 1900’s. It was noted by early practitioners, that as a side effect of the fusion operation, pain levels in these TB sufferers also reduced, and it was for this reason, that these Surgeons felt it would be a good spinal treatment.
But for the last 6 years, I have been unable find any facts or figures that would prove to me that this treatment has any ‘long term’ benefits for patients, but I am well aware of many family, friends and forum buddies who have gone on to receive 2nd, 3rd and sometimes 4th procedures as the lack of mobility in the spinal system, creates further stress and strains upon the remaining vertebrae!
To put it mildly, morbidity inducing fusion, is as far away from dynamic and minimally invasive MISS surgery as you can get!
I am sorry to have to say this, but judging from the resume Dr. Brager would have provided, I am pretty confident that your discectomy was not an (MISS) procedure. However, I am sure that 'we are all' very glad that you are benefiting from his procedure anyway, no matter what it was called.
This positive outcome for you ‘may mean’ that Dr. Brager is one of the ‘better Surgeons’ who have risen to the challenge of the unstoppable march of (MISS) spinal surgery in the good old, US of A!!
Best wishes
SPINELF