More useless surgeries

Last week I discussed surgery for meniscus tears, which many studies have proven to be useless. Here are more useless surgeries:

• Spinal fusion ("welding" together adjacent vertebrae)
• Vertebroplasty/Kyphoplasty (injecting a sort of cement into the spine to shore it up)
• Appendectomy (removing the appendix; apparently most can be avoided by antibiotic treatment)
• Coronary stenting (placing a tube inside an artery to open it up)
• Shoulder surgery for impingement (removing a bit of bone from the outer end of the shoulder blade where arm bone “impinges”)
• Ruptured Achilles’ tendon surgery (wearing a boot works just as well)
• Many fracture surgeries (if the bones are roughly aligned, they will heal themselves)

There are actually many more useless surgeries. My principle source for this information is Ian Harris, MD, PhD—an Australian orthopedic surgeon and professor of orthopedic surgery who directs a research unit that focuses on surgical outcomes. He admits to performing surgery that doesn’t work. Sometimes, he says, “If a patient complains enough, one of the easiest ways of satisfying them is to operate.” The title of his book, by the way, is Surgery, the Ultimate Placebo. If we expect a treatment to work, it is more likely to be perceived as working.

Dr. David Kallmes of the Mayo Clinic, believes that doctors continue to do some of these operations because insurers pay and because doctors remember their own patients who seemed better afterward. “I think there is a placebo effect not only on patients but on doctors.”

Not everything can be fixed.

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