elective surgery

COVID-Delayed Surgeries & Lumbar Stenosis Research

CF 288: COVID-Delayed Surgeries & Lumbar Stenosis Research


Today we’re going to talk about COVID-Delayed Surgeries & Lumbar Stenosis Research


But first, heres that sweet sweet bumper music


Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while  we make you and your patients better all the way around.


We’re the fun kind of research. Not the stuffy, high-brow, look down your nose at people kind of research. We’re research talk over a couple of beers.


I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together.


Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, drive, smart, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at creekstonecare@gmail.com


If you haven’t yet I have a few things you should do.

  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent educational resource for you AND your patients. It saves you time putting talks together or just staying current on research. It’s categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams.
  • Then go Like our Chiropractic Forward Facebook page,
  • Join our private Chiropractic Forward Facebook group, and then
  • Review our podcast on whatever platform you’re listening to
  • Last thing real quick, we also have an evidence-based brochure and poster store at com


You have found yourself smack dab in the middle of Episode #289


Now if you missed last week’s episode, we talked about Mindfulness For Knee Replacement & The Use Of Tuina.

Make sure you don’t miss that info. Keep up with the class.


On the personal end of things…..

I’ll share with you all that I’ve been messing around a lot with AI and how it can make my life easier while saving me money. And it has.


What I’ve figured out so far:

  1. I used to have to hire a virtual assistant off of Upwork to create my personal website blogs. I would always go in and take out the vitalist, philosophy stuff and make the blog mine but, for the bulk of the blogging, they would do it. Now, AI does it. I do the same process on my end but it doesn’t cost me nearly as much each week. In fact, the assistant, come to find out, was using AI and charging me as if they were the one creating it all. Now, I’ve cut out the middleman and saved money.
  2. I was intimidated in the beginning, but I recently started experimenting with lots of AI image creation apps. I finally settled on one I really like and now, I can make unique, non-copyrighted images for my blogs, social media, etc. No more lame images off of Pixabay to find a non-licensed image anymore. I just make my own and, I have to admit, it’s kind of fun.


There is definitely a learning curve on AI right now but once you’ve crossed the threshold, it’s all downhill and life is good. I have some crude southern sayings to describe the easy life but I’ll save those for personal, one on one conversations if we ever meet in person.


So that’s what’s been on my radar lately.


Also, there is a group here in Texas that is buying percentages of practices. You still run it as you always have but they do the HR, billing and collections, AR, etc. All of the soul sucking parts of practice. No name change and the valuation and offering for 60% is more than fair.


That’s on my radar. We might do that. Life would smooth out if we did some of that. Keeping up with this machine without a dependable billing/collections dept is just a train wreck and hurts the heart pretty much every week.


As always, as we make our way through the mud and muck, I’ll be sure to keep you updated.


For now though, let’s get into the research, shall we?



Item #1


The first one today is called “Patients who delayed non-emergency surgeries during the pandemic are returning for care” by Beth Kutscher and published in LinkedIn on June 29, 2023. Dayum. That’s hot.



Why They Did It


The patients who postponed non-emergency surgeries during the pandemic are now seeking care, leading to an increase in surgical volume.


This has sparked a discussion about the necessity of these procedures. The motive behind studying the prevalence of unnecessary surgeries is to identify potential areas where healthcare resources and costs can be optimized.



How They Did It


  • The analysis involves studying the rates of surgical procedures and identifying cases that may be deemed unnecessary.
  • The Lown Institute conducted a controversial study that identified over 106,000 potentially unnecessary surgeries between March and December 2020.
  • However, the study’s methodology and conclusions were criticized by the American Hospital Association for having limitations and flaws. Other studies have also shown significant variations in surgical rates across countries and states, such as the high c-section rate in the United States and the discrepancy in lumbar fusion rates.


  • Vijay Yanamadala, a spine surgeon, conducted his own research on unnecessary lumbar spinal fusions, estimating that over 50% of such surgeries may be unnecessary. He also referenced the Lown Institute data, which suggests that back procedures, including vertebroplasty for osteoporosis and spinal fusion for back pain, contribute to about one-third of unnecessary surgeries.


  • Yanamadala wears two hats in this context, serving as a neurosurgeon and also as the chief medical officer for Sword Health, a company providing digital physical therapy.



What They Found


  • The Lown Institute’s study identified a large volume of potentially unnecessary procedures.
  • Yanamadala’s research specifically focused on lumbar spinal fusions and suggested that over 50% of them could be unnecessary.
  • Back procedures, including vertebroplasty and spinal fusion, were found to account for a significant portion of unnecessary surgeries.



Wrap It Up


  • The analysis of surgical procedures suggests that there is an issue with unnecessary surgeries in the healthcare system.
  • Factors contributing to unnecessary surgeries include poor compliance with physical therapy before surgery and the profit-driven nature of the U.S. healthcare system.
  • While elective surgeries are profitable for hospitals, there is a shortage of physical therapists, and certain specialties, such as neurosurgery, are more sought-after than non-surgical specialties like spinal cord injury fellowships.


  • The findings emphasize the need for a more balanced and patient-centered approach to surgical decision-making. Optimizing healthcare resources, improving compliance with non-surgical alternatives like physical therapy, and addressing the disparities in access to appropriate care are important steps toward reducing unnecessary surgeries and ensuring that patients receive the right care.




Before getting to the next one,


Next thing, go to https://www.tecnobody.com/en/products That’s Tecnobody as in T-E-C-nobody. They literally have the most impressive clinical equipment I’ve ever seen. I own the ISO Free and am looking to add more to my office this year or next. The equipment you’re going to find over there can be marketed in your community like crazy because you’ll be the only one with something that damn cool in your office.


When you decide you cant live without those products, send me an email and Ill give you the hookup. They will 100% differentiate your clinic from your competitors.



I have to tell you, Dr. Chris Howson, the inventor of the Drop Release tool re-activated the code! Use the code HOTSTUFF upon purchase at droprelease.com & get $50 off your purchase. Would you like to spend 5-10 minutes doing pin and stretch and all of that? Or would you rather use a drop release to get the same or similar results in just a handful of seconds. I love it, my patients love it, and I know yours will too. droprelease.com and the discount code is HOTSTUFF. Go do it.


Item #2


Our last one this week is called, “A prospective study of non-surgical versus surgical treatment for lumbar spinal stenosis without instability” by Jung et al.  and published in PubMed on August 17, 2020.




Why They Did It


This study compared non-surgical and surgical outcomes in surgical candidates for lumbar spinal stenosis (LSS).



How They Did It


  • Surgical candidates for stenosis were prospectively screened.
  • Patients were offered the option to be enrolled in a randomized cohort, an observational cohort, or not to participate.
  • Patient-reported outcomes were evaluated at baseline, and at 1, 3, 6, and 12 month
  • The primary outcomes were measures of pain and functional outcomes such as the Korean version of the Oswestry Disability Index (K-ODI), the EuroQol 5-Dimension instrument (EQ-5D), and 36-Item Short-Form Health Survey (SF-36).



What They Found


  • 110 patients were enrolled in the randomized cohort and 37 patients in the observational cohort.


  • Among them, 97 patients received non-surgical treatment, and 50 patients underwent surgical treatment.


  • At 12 months, the non-surgical treatment group had less improvements in the primary outcome measures of back pain, leg pain, EQ-5D utility index and EQ-5D VAS.


  • Most SF-36 section parameters also showed less improvement in the non-surgical treatment group than in the surgical treatment group throughout the 12-month follow-up.


Wrap It Up


In stenosis patients without instability, non-surgical treatment resulted in less pain improvement and functional recovery through 1 year.



Alright, that’s it. Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.


Let’s get to the message. Same as it is every week.



Remember the evidence-informed brochures and posters at chiropracticforward.com.



Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

Chiropractic evidence-based products

Integrating Chiropractors

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.22-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.33-AM-150x55.jpg

This image has an empty alt attribute; its file name is Screen-Shot-2018-07-12-at-10.23.09-AM-150x55.jpg

The Message

I want you to know with absolute certainty that when Chiropractic is at its best, you cant beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.


When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.


It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.


And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!


Key Point:

At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….


Thats Chiropractic!



Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes.


Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms.


We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference.



We cant wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.




Social Media Links



Chiropractic Forward Podcast Facebook GROUP











Player FM Link









About the Author & Host

Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger