Corporate Spine: How Spine Surgery Went Off Track- Interview with Dr. Ardavan Aslie

intro: 0:01

Get ready to hear the truth, the whole truth, and nothing but the truth about the United States healthcare system with your host of the medical truth podcast, James Egidio.

James Egidio: 0:19

Hi, I’m James. welcome to the medical truth podcast. Each year, an estimated half million people will undergo spinal fusion surgery in the United States In most cases, surgeons will implant rods and screws into a patient’s fused vertebrae as part of the procedure. There’s just one enormous problem. According to the published medical literature, the screws provide little to no benefit for patients. My guest is a board certified Harbor train university fellow spine surgeon who recently published his book called corporate spine. How spine surgery went off track and how we can put it right. In his research, he sounds the alarm with overwhelming evidence that per pedicle screws used for spine surgery often do more harm than good. Even though device manufacturers continue to push profits over patients. It is an honor and a pleasure to have on the medical truth podcast. My guest, Dr. Ardavan Aslie. Dr. Astley, welcome to the medical truth podcast. How are you doing today?

Dr. Ardavan Aslie: 1:21

Doing very well. Thank you for inviting

James Egidio: 1:23

me. Absolutely. A little bit about who you are and what you do. Yes.

Dr. Ardavan Aslie: 1:29

I’m a orthopedically trained spine surgeon. That means I did a residency in orthopedic surgery. Then I did a year of fellowship in spine surgery. And I’m a practicing spine surgeon here in Sacramento area in Northern California. And the reason I said that because there’s two ways of becoming a spine surgeon. One is through orthopedic surgery. The other one is through neurosurgery. So you can become neurosurgeon and then. Learn spine surgery and practice as a spine surgeon. I see.

James Egidio: 1:59

So you’re a spine surgeon through the orthopedic route. Correct. Yes. Okay. So you wrote a book called corporate spine, how spine surgery went off track and how we put it, let’s talk a little bit about some of your findings and research when it pertains to spine surgery.

Dr. Ardavan Aslie: 2:21

Sure. Boy, where do I start? Because it goes way back. I’ll tell you how it all started. I’ve been in practice for 20 years. The first 10 years, I practiced basically what I was trained, what I was told. I did everything by the numbers, and I did very well. About 10 years, like into 10 years of my practice, I became very dissatisfied. I was like, what are we doing to our patients? I started asking questions. Then I said, maybe I can find better methods of what we’re doing. And then that led into some inventions that I had. And actually one of my inventions won an innovation showcase in Congress of Neurological Surgeons. So I won an award actually for my invention. Then as I was developing that, I had some problems that I went back and had to study the literature that we have to see if this problem exists or is just a problem that I have faced. And what I found out was jaw dropping. What I found out in literature was, just bad. And basically what I found out in literature was that paper after paper shown that the methods that we use these days in spine surgery don’t work. So I was like, wait, what is going on? So I started digging deeper. I started going to these conferences and actually. Start talking to the so called leaders of the field when we go to conferences, let’s say North American Spine Society or American Academy of Orthopedic Surgeons these lecturers that are university professors, after the lectures, I would it’s Approach them. I start talking to them. I start asking these questions. What is going on, which I’m going to explain what I’m talking about, and they would just not answer me. They would just want to just tear me apart. As soon as I start questioning the methods, they not only they didn’t want to hear it. The questions, they actually, they reacted like I was just like insulting them or something like that. It was just such a bad reaction from professor to professor. And I have to say. What is going on? Why is this like this evidence, these papers that’s been published in our own literature, these guys know about these papers. So why is this such a resistance to this wealth of knowledge? So I spent about four years actually to find out what the answer is. And I eventually found the answer, and I will explain. Let’s go back to see how the spine surgery started. One of the spine is a bunch of bones that are stacked up on top of each other. Like this. A bunch of bones that are stacked up on top of each other, separated by these cushions we call them discs. These discs are cartilage. They’re like a jelly donut. They’re like a they have a jelly in the middle and then the tough ring around it. So it’s like a cushion. If there is a stress like a car accident or fall, this can get ruptured and the jelly can seep out like that. And therefore, slowly over time, a good spine can become a diseased spine and causing pain. Initially, in 60s and 70s, we had x rays. We didn’t have MRIs. We could get an x ray and see that the disc between the two bones had gone bad, and we called that degenerative disc disease, because we didn’t know what was going on with the discs. Treatment for that, we came up with a treatment, and the treatment for that was a surgery called fusion surgery. In this surgery, you would go in from the front and the back, take the disc out, and this is an example of a fusion surgery. So you go in, take the disc out, put a spacer here, and then you go through the back, put some screws and rods. Basically, you mobilize These two vertebrae, so the two vertebrae become one bone. So the disc is gone, now the bones have been mobilized. That has eliminated the motion and eliminated the pain. This surgery actually started working pretty good, except there was a problem. Every time you do this surgery, You’re hoping that within the next few months, the bone will grow between the two bones to the middle of that prosthesis and the two bones become one. The problem is in some number of people, that didn’t happen. And we call that a nonunion. And that is basically patient’s biology. In these cases, the pain came back a lot worse. And the results were very bad. So we were all looking to somehow increase this fusion rate, and the fusion rate without the screws was about 75%. So 3 out of 4 people will heal it, 1 out of people, 1 out of 4 will not, and they end up in the non union. So right around late 80s and early 90s, a couple of surgeons from France, figured out a way to put a screw into the backbone. Now, backbone is a very complex bone, but we somehow found a way to insert a screw we call pedicle screw. It’s a large screw that has a tulip that can accept a rod. This is Screw gets inserted from back to the front. So if I have a picture of it, this is the back of the spine, you can see from back to the front is inserted through what we call pedicle. Pedicle are these bony columns that connects the front part of the vertebrae to the back part of the vertebrae. So these are pedicles, right? Basically two bone. And this is the surgery. So you put the screws from Back to the front and these can accept a rod. You put a rod between them and tie them so that Immobilizes the spine and hopefully increase the fusion rate. Why? Because as orthopedic surgeons, we learned quite a bit in the 60s and 70s in terms of fracture fixation. We developed a technique called AO spine. I’m sorry, AO technique. AO technique is what we call rigid fixation of fracture ends. When a bone breaks and you have these two ends that are floating, What you do in orthopedics, you do a surgery, you open up, you expose the bone, then you put the bones together, end to end, and you put a plate next to it with some screws going, and that way you fix this fracture in a rigid fashion, we call the rigid fixation. This worked very well for the fractures, and as orthopedic surgeons now doing spine surgeries, we said, Oh, huh, somebody figured out to put a screw in. And we know that immobilization is the key for healing. So therefore, let’s apply that knowledge to spine. And that’s when we started doing these surgeries with addition of the screws, except there was a problem initially. So we started like early nineties, late 1980s. We started doing, adding these screws, except there was a problem. There were really. Bad results. At some point in 1993, there were about 7, 000 lawsuits against the manufacturer of these screws, a company called currently Medtronic, and it was really bad. Actually, there was an investigation by Senate at some point. They brought in leaders of the field to Senate and start asking them questions. Right around that time, in 1993, a surgeon called Dr. Zdablik. published a key study paper in 1993 in Spine Journal. According to his paper, he said that these screws work beautifully. It just worked absolutely awesome. He had people that didn’t get the screws, and people who had the screws, and the ones that they got the screws, they did tremendously better. This gave a green light for the surgeons to start using these screws as an adjunct to the fusion. Now, not to confuse you, I got to understand, you got to understand that the fusion has two parts. One is the fusion, which is putting the bone between the two bones. And the second part is instrumentation, which putting the screws. For a fusion surgery, you, you can or you don’t have to put the screws in. I want the audience to understand that. By late 1990s and early 2000s, and currently, these screws are standard of care. This is what we do. If you have a fusion surgery in the neck or the lower back, you’re getting these. Here I come, and I had a problem with my device. I said, let me look at the literature. When I looked at the literature, I found six multi center, multinational papers that were published in our journal, Spine. So there were not some papers that got published in some, not so important journals. They were published in our own journal, and they were multi center and multinational. And all six said that addition of these schools Don’t change the outcome or fusion rate. Basically, they were saying that by adding the screws, all you’re doing is increasing complications. When I saw that, I was like, wait, that doesn’t sound right. You know what is going on here? Let me look at the, there’s a doubtless war. See what is going on over there. And that’s. When I found out, Oh my God, what is going on? Whatever I’m saying that I’ve found out, it’s not conspiracy theory. It’s in Google. It’s a known fact. It’s a published data. So in 1993 there were about 7, 000 lawsuits against the manufacturer of the screws. Medtronic, I mentioned that, right? Dr. Zdeblik publishes this paper in 1993. By 1996, as those losses were disappearing because of his paper, he started getting paid from the company. By 2003, he’d gotten paid 34 million dollars allegedly for something that he’s invented, which I cannot comment on that. I’ve seen it. Let’s not talk about that part. That’s bad. I was like, Whoa, that’s bad. Wait, it gets worse. It gets 10 times worse. So like in early 2000s. The Medtronic came up with another product. This product was a very important product. It was a substitute for bone graft. Originally, I said that for the fusion, we have to put a block between the two bones. When you take the disc out, that space is void. So you have to put a spacer there. We normally have to harvest patient’s own bone to put it between the two bones. That causes problems because now the donor side of where you hacked out the bone now starts hurting. So we were trying to avoid that. So Medtronic came up with a product. It’s a hormone that we all have it. When you break your bone, it gets excreted. We call it BMP, bone morphogenic protein, and that stimulates bone healing. The company actually isolated that And it came as a product in a sponge that we can put that sponge between the fusion, between the bones that we have to fuse so the fusion can take place so we don’t have to harvest. wE started using this product in the early 2000s. We had to study that. So Medtronic put Dr. Zdeblik again in charge of this important study. And he published a paper, Dr. Zdevlic published another paper for this new product in 2004, except this time he got caught falsifying his results. By who? By the United States Senate. There was a whistleblower right at that time One of the workers, one of the employees of the company said that these doctors are all getting paid from the company, like just amazing number of amount of money. So that triggered a United States Senate investigation, United States Senate investigated, and it was the United States Senate that concluded that the paper that Dr. Zdeblik published in 2004 was not written by him, was written by company. I’m like, Oh my God, this is just crazy. Now let’s go back to that paper that he published in 1993. That’s even worse. Every time I think to myself man, this is really bad. It can’t get worse. It does. So let’s go back. I said, I got to study that paper in 1993. This is just crazy. There are a lot of problems with that study that I’ve mentioned one by one in my book. But the biggest problem with that paper is that. It got published as a preliminary report. I spent about two years to find the final result or follow up result, and I couldn’t. Eventually, I cornered one of these leaders of the field, and I asked him, I said, I can’t, what is it? And he said, Oh, that preliminary report is the only thing that we have. There is no, that study was abandoned in the middle and was never finished. I was like, Oh my God. If you Google Zdeblik spine fusion article right now, you will see that article. You will see that it was published in 1993 and, most importantly, has been referenced in 1, 127 articles as of today. That article is the most referenced paper in the entire world of spine surgery. Everything that we do tracks back to that one unfinished paper by a guy who later on got caught cheating. And this is all known published data that we have. So I was like, Oh, my God, that’s really bad. So to top that off now, wait, it gets worse again. That’s bad. Worse again. There was another paper that got published in 2018. This was a paper that had eight year follow up. It was a very big study. We are anticipating it. And it was a very good study, and it got published in 2018 as a lead article, so a very important article. This article, they looked at using the screws, and they concluded that adding the screws does not add to the benefit to the patient.

James Egidio: 17:16

Yeah, I have one question for I want to back up a little bit about what you’re talking about here because you mentioned something very interesting about some of the side effects or some of the risk and benefits of these of this surgery based on the use of these pedicle screws. What are some of those side effects?

Dr. Ardavan Aslie: 17:36

Sure. Let’s talk about that.

James Egidio: 17:38

I’m sure there’s some people that are listening that may or may not have had some surgery done back surgery, spinal fusions, and may have even had these particular screws inserted in them. So they, it would be great to talk about that.

Dr. Ardavan Aslie: 17:52

And the problem is. Many fold. One, the worst problem that I can think of is the amount of dissection that you have to do. If you look at these screws, let me give you an example. If you look at these screws are inserted from corner to corner. So they’re on both outside corners of the bone. So to put those screws in, you have to open up the spine this wide. You have to scrape the muscle off the bone from corner to corner. Literally strip the muscle off the wall, and all of these are very important muscles. That amount of dissection, it just basically kills the paraspinal muscle. It just scars it. I have had to gone back, go back a few of my patients to do, redo surgery. And when I go back, that muscle is dead. It’s just scarred. For multiple reasons. One the muscle gets scarred. Two, when you put these screws in, this hardware. The muscle cannot go back and attach itself to the bone anymore. So you literally kill the back muscles. That has very important consequences to the patient. Why? And I’ve mentioned that in my book, spine surgery. And sometimes I tell my patient spine surgery is something that. It’s like a controlled trauma. If you, if let’s say somebody doesn’t have any back issues at all, they have a perfect back. We do this surgery on them. They end up in back pain. So the surgery introduces pain to a patient. The question is why do we do these searches? Wait a minute. What are you saying? Why do we do this surgery? The reason is this because the pain is not just one entity. There are different type of pain severity and all that stuff. The pain that comes from the disc is a. Unbearable, sharp, stabbing pain that you can take all the narcotics in the world till you’re barely breathing. You’re still going to have that pain. That’s not going to take that pain away. So that is a pain that you just no treatment for it. The pain that you get from the damaged muscles is a dull, achy pain that you can take a pill here and there. You can get a massage and you can manage it. It’s not. It’s not unbearable. So in a way, the back surgery replaces an unbearable pain with a manageable pain. That’s why we do these surgeries. And that’s why, even though we’ve done this and we’ve ruined your paraspinal muscles, patients are still happy because they’ll still tell you this. Oh yeah, I will take it again. Because the other pain that I had, I couldn’t live with that. That was just awful. So that’s why we do it. So that’s one thing that these screws do to you. One is just wreck your back and wait, it’s even worse. The worst problem with these is in the cervical spine. So this is the cervical spine. When we do like a back cervical surgery, you have to open up the neck from, I got it from corner to corner. You literally go in and scrape the muscle off the bone from corner to corner because in the neck, you have to put two screws at the far end. I’m sorry. I just so you have to put two screws at the far end here and the far end here. So that amount of dissection. It ruins somebody’s life. They are done for life, so that’s one problem. Two, you put these screws into these bone columns and guess what’s underneath this column right here? It’s the nerve that’s trying to come out. So we are putting these screws millimeters away from the nerves. So putting the screws is safe these days, but once in a while you put the screw either through the nerve or close to the nerve, and the patient wakes up, they either cannot move their toes, or they’re in severe pain. So one problem is a nerve damage. And of course, the third one, I would say, is the price. These screws have absolutely bankrupt the healthcare. The cost that are associated with these screws is astronomical. For example, the screw itself costs about anywhere between 600 to$1,000 dollars each. so that cost by itself is quite high. Now, you just don’t put the screw in to put the screw in you need people in the operating room you need one guy that runs the x ray so you can see where you’re going. You need another guy that does neural monitoring. When I do surgery, I have a. person in the O.R. that has a machine that’s been connected to all the upper and lower extremity and monitors the nerve. So if I get close to a nerve, you can tell me that I’m too close. I gotta move away from it.

James Egidio: 22:52

Now, would that be? Would that be a neurologist?

Dr. Ardavan Aslie: 22:56

There is a technician in the room, but there’s a neurologist in their center that’s like looking five or six different surgeries at the same time. Okay. Okay. So the person that’s sitting there is just a technician. He must be a licensed technician. He has to go through training and all that stuff. But they all go to a center and one neurologist, I think, I’m not sure. I think that’s what’s happening. So that’s that. Two, after you, or four, after you put these screws, you need CT scan and additional x ray to see if you put these screws in the right side. And if you put it on the wrong, spot. You have to take the patient back and reposition and redo it. It’s crazy, but that’s not the worst part. That’s of all the things that I told you, that’s not the worst part. The worst part is it is that it doesn’t work very well. And I’m going to explain to you why. So originally I mentioned that boy, there are all these papers that screws don’t work. So when I present this data, To the leaders of the field that and they know what’s going on. They are aware of these papers When I presented this data to them, they just don’t want to talk to me. They want to just rip me into shreds. I kid you not. They’re just like, why? Because spine surgery went through quite a bit of trauma in 1990s. They brought all these leaders of the field in Senate and they questioned them. I’m opening the old wounds. That’s why it’s so traumatic to them. But I have to tell myself, why? Why is that? Why is there such a resistance to data? If you’re not going to listen to research, why do research? Just maybe. Maybe this research is trying to tell me something. Let me explain to you a story so you know the severity of this problem. Now, one of the things that audience might ask you is that have you brought it with leaders of the field? Have you done this? Have you? Absolutely. I have done everything possible. And writing the book was the last resort. I didn’t run to write a book. That was the absolute last resort. So one time, I was in North American Spine Society in 2016 in Boston. I got up in front of a thousand other spine surgeons and I said, These are, I have six. Multinational, multi center papers said these screws don’t work. However, these screws are a standard of care. Why? So I didn’t want, I was, at that time, I was just starting to ask these questions. I didn’t know what I know now. So I didn’t want to fight. These are leaders of the field. I don’t want to piss them off. I don’t want to make them upset. So the the panel gave some sort of a answer. Oh, we did look at it and we’re going to look at it. And then I sat down anyway. I didn’t want to pick a fight. I sat down 20 minutes later in the intermission, I’m in the line to get coffee. I was talking to a surgeon and he introduced me to the surgeon behind me that was standing in the line. I turned around and this surgeon, my friend. told him that gentleman that, Oh, Dr. Asney doesn’t like the screws. He turned around to me and he was a older, like in sixties, early sixties, very well known. He said, Oh, you’re the gentleman that made that comment about the screws. I want to tell you that everybody’s welcome to their opinion, but you’re very wrong. I said, it’s not about me. It’s about the research. I’m not saying anything. All I’m saying is that there’s research says. Stuff doesn’t work. Maybe, just maybe, he’s trying to tell us something. He said, I know. I published those papers. Those are my patients. I’m like, oh, what’s your name? He told me his name, which I’m not going to mention, and it was true. He was right. I had the papers in my hand. I looked at him. He said, see, that’s me. It was the second paper in my stash. See, that’s me. He was the fifth author. So I said, this is you because yeah, that’s me. I said let’s read what your paper says. At the last sentence, word for word, the paper said, based on current evidence, we do not recommend routine use of pedicle screws. He looked at it. He looked at it again. He said, no, that’s wrong. And he walked away. I kid you not. This is not some story that happens. This has happened to me, but that’s what I’m dealing with. Yeah, so yeah, so I have to answer this. I have to say what is going on. I’ve spent about four or five years trying to come up with biomechanics, trying to innovate, and eventually found the answer. And this is what the answer is. We are orthopedic surgeons, as I said earlier. We do five years of orthopedic surgery, and in that five years, all we learn is fracture fixation. Every time we’re in the emergency room, trauma comes in, femur fracture, tibial fracture, we fix those. And then we do one year in spine surgery fellowship, one year, that’s it. And then we go out and become spine surgeons. What we did then, what we learned from orthopedic surgery, we got that knowledge and we applied that knowledge to spine surgery. Now I’m here to tell you that we should have never done that. Spine surgery was never meant to be a subspecialty of orthopedic surgery. There is nothing in spine surgery that overlaps with orthopedic surgery. There is nothing in orthopedic surgery that’s going to make you a better spine surgeon. Zero. None. At all. And I’ll explain why. Earlier in my argument my presentation, I talked about rigid fixation. You break a bone, you put a plate, you shoot some screws, and that holds the ends together in a rigid fashion. Rigid fixation works well in arms and legs for one important reason. Because in arms and legs you can eliminate gravity. You can put the patient in sling or you can put the patient on crotches so you don’t have to put weight on it. In spine, you can’t eliminate gravity. You can’t tell the patient to lay down for four months at a time. So the second that patient gets up, that structure is under tremendous amount of stress, constant stress. So the concept is no different than Building high rises in the earthquake zone like San Francisco. We’ve learned that when you build a high rise in the earthquake zone, you don’t make it stiff. You make it flexible, not flexible, but bendable. So you can bend when the earthquake comes in, can bend and dissipate energy and not crack and fall and just everything. That’s the same exact concept. So in the spine surgery, we can’t have rigid fixation just cuts out. And so we have to have a device that can not flexible, can bend and twist. And so somebody, if it fall down or Something happens to him. Don’t cut out and come out and be all fail. It can twist and turn and dissipate the energy and doesn’t lose the grip, right? That’s 1 of the things. Yeah,

James Egidio: 30:13

I want to talk to a little bit about before I introduced the book and we close about. What are some of the underlying causes for compressed spine, a compressed spine and degenerative disc disease number 1 and who is ultimately responsible for the use of these pedicle screws Who does the responsibility fall on? So I guess to answer the first question is what are some of the underlying causes for degenerative disc disease?

Dr. Ardavan Aslie: 30:43

So this is the situation that makes answers to that question really difficult. And one thing I want the audience to understand is that spine surgery is a very young field. Invention of MRI that we could actually see these discs following and try to figure out what’s happening to them and good MRIs were not available till 1995. So if you think about it from 1995 till now, we’re talking about 25. 28 years. That’s it. That’s not a lot of time for us to figure out and answer all of those questions that you just asked. But, we are understanding that at some point, something happens to the disk. This doesn’t just fall off and just, bust it. Now, I got him set. There are two. Bad. This is not just a one. This is a spectrum. On one end, you have patients that they have bad quality tissue, bad cross linking of their of their Collagen, collagen fibers. Even though they look, they just look good, but it’s weak. And then on the other spectrum, you have people that are very healthy and their disc qualities are very good. So what happens is that at some point, Patients do something, let’s say they fall off a horse, they get into a car accident, and the disc gets injured. Now, a couple of things can happen when the disc gets injured. One is that you can have pain, and just misery, and you go around, you look for treatment. So you have the symptoms right away. The other thing that can happen is that you might not hurt. You might hurt for overnight, one day you wake up, you’re like, oh my back is sore, and then I’m okay. So even though the disc is torn, but you really don’t have that pain. What happens is that over time, because of the size of that tear, that mushy stuff starts coming out and the discs start settling, but it’s not causing any problem. So it’s not causing any pain. Then down the road, one day you could do something very trivial just trip over something or get a very light car accident. That area becomes inflamed and now you have pain because one important topic that I want my patients to understand is that Damage does not necessarily equals pain. Damage plus inflammation equals pain. It’s the inflammation that causes the pain That’s why people have good days bad days for example If we MRI hundred people at the age of 60 60 70 people to have all sorts of damaged disc and you know This that are a smooshed or whatever, but only one to 2 percent of those people are in pain. So why? Somebody sustained the same exact injury with a busted disc and herniated disc and is in severe pain Another guy in the same car accident has a busted. They can lose looks exactly like that and they have no pain Yeah, we don’t understand that part. We don’t

James Egidio: 33:50

know. Yeah. What about obesity? The center of gravity with the body and all the weight that people put on through, bad dietary intake and gaining weight and gaining a lot of weight. Doesn’t that put any pressure on the spine to where, it just pushes gravity down and compresses the spine.

Dr. Ardavan Aslie: 34:07

Absolutely. Absolutely. These discs are Cartilage. So you want to, yeah. Put least amount of pressure as you can and two things are very important your weight and your job So let’s say I have a lot of patients that they come in and they are hard workers There’s some of them are you know carpenters mechanic or movers or so, so I tell them look you don’t need surgery You need to get a new job. That’s what you need to do. Why? Because it’s always the lifting that aggravates your back lifting. It’s not pushing, pulling. It’s not, there are different levels of aggravation. Of course, you can be in a car ride for about two hours and then you wake up and you’re like, Oh, my muscles. But that’s a different type of injury. That’s like just muscle soreness, but something that aggravates your back, sets you back that you cannot sleep. You have to go get chiropractic care. Those. Always caused by lifting because the spine, these discs are basically holding you all your weight and whatever you’re lifting goes right through these discs. Basically, these discs do not share the weight with anything else. So if you are heavy, especially now, you got to understand there’s a whole physics involved as well. I explained to my, let’s say you have extra one pound and you’ve got to walk upright. Your muscles, your spine gotta balance this with pulling back about one pound. So guess what? Both these weights pulled down on the spine. So if you lose one pound from your gut, you take two, three pounds pressure off your spine. That’s how important spine is like a flagpole, all to stay upright, all the pools got to equate. So if you have extra one pound here, your muscle, your muscles got to balance with it. And they all. So that’s why losing weight is super important to get your back healthy. But of course this happens, it’s not just heavy people that get a back issue. I have kids that are skinny, they still have bad, why? Because their disc is low quality. And we just can’t tell what the quality of this is by just looking over the MRIs, right?

James Egidio: 36:22

One last question before we close and we introduce the book is, again, who is ultimately responsible or to blame for the use of these pedicle screws?

Dr. Ardavan Aslie: 36:33

You want me to say it?

James Egidio: 36:35

Yeah, go ahead. Companies. Okay. Companies. You say companies though, and you do say companies, but I would think Personally they have to obviously go through FDA approval, right? Correct. So when the FDA be responsible because they’re like the first line of defense when it comes to approval of any yes.

Dr. Ardavan Aslie: 36:58

Yes. Medical. Correct. What I’ve learned now. I don’t know. I’m not going to say what I’m about to tell you. Is it true? I’m going to tell you what my experiences was with FDA, what I’ve learned when I’ve gone through these Development and stuff what I’ve learned from FDA You gotta understand FDA is not a body that can test everything. They’re not a university. They cannot run research, FDA all it does It can determine if that device is safe or not. They cannot go test everything. And they depend on the data that the company presents them. This is the problem. Company goes in and finds doctors, and I’m pretty sure they can find a doctor that can fudge the numbers and write papers that are favorable to the product. Oh,

James Egidio: 37:45

no question about it. I’ve interviewed several physicians that We’re talking about just that they were talking about the fact that these papers that are put out for these Are all written by a lot of them are written by ghostwriters. In fact, just yesterday. Dr Scott Jensen was reporting where a lot of the old articles when I say dated articles were scrubbed from the internet And they’re scrubbed from some of these online sources as credit supposed to have been credible sources for information. So a lot of data is being fudged and a lot of data is being scrubbed, like I said, from the Internet.

Dr. Ardavan Aslie: 38:27

I want to show you something. This is what I brought. I want to show you something. So you understand that I am not the only one saying this. I’m not some conspiracy theorist that was starting about this. Now, this is our journal, Spine Journal, and I want to This is a November 2020 article. Let me see if I can put it in front of this. This is a November 2020 article and I’m going to read you the leading article. The leading article says undisclosed conflict of interest is prevalent in spine literature. Our journal is telling us that our data is tainted. And nobody does anything about it. That’s why I wrote that book. And in that book, I said exactly what’s happening. The CEO of a company has one goal and one goal only. To make as much money as they can at that time that he’s the CEO. That’s his goal. Go. So what he does, he approaches, he gets a couple of these surgeons, they write papers they get that data that is totally fudged to the FDA, FDA trusts these guys, say, okay, that’s fine, this is good, and then FDA approves it. So I don’t put the FDA at fault because they just don’t have the power, they don’t have the there was an ability to actually see if a product works or it doesn’t work. All they can say is that if this product is safe or not safe And it’s left for the it’s left for the universities like harvard johnson To for these universities run the experiment to say if they work or don’t work. So 10 years later we find out that product didn’t work nobody says anything. They just move on to the next product, and I’m like no. Come back here. Why? Why is this so important? Because it’s not about that product. This is why is the problem. When a product, when you publish a paper that says this product works, then me as another surgeon, I am trying to improve upon the work that’s been done behind me. If the work behind me was fraudulent, I’m going to go in the wrong direction. So the way I explain is that not only the patient that received that treatment are they got basically defrauded. The entire people that suffer from back pain has been defrauded because these fraudulent paper makes the entire spine surgery go in the wrong direction. For example, and the best example of it is that one paper that Dr. Zdeblik published in 1993. Nobody can duplicate those reports and because of that paper, when there was so much debate about these screws, because of that paper, one single paper, the entire field went in the wrong direction. And now, these young people, wait, I gotta tell you something else, lying. I’m gonna, I’m gonna say this is very important. I go to conferences twice a year. Twice a year from 2002 that I finished my training. Every time I go to these conferences, a leader of the field gets up and says, there’s Plenty of evidence that shows these screws work. Ask this. If you ask another surgeon, they’re going to say the same thing. Yeah. Every time we go, somebody gets up. Six months later, when I go to another conference, somebody else gets up and says, there’s plenty of evidence that shows these screws work. And then on and on. So throughout time, we have made ourselves believe it. That, oh, yeah, screws work beautifully. At the same time, there’s no evidence. One time I got in a fight in 2018 with one of the professors. He turned around and says, there’s plenty of evidence that says the screws work. And I said, it does not work. So we have not only we haven’t fixed anything, we have lied to ourselves that these screws somehow work. Why? Because we’ve been trained that’s how you fix something. And the training is wrong. Sure.

James Egidio: 42:32

Dr. Aisle I want to close with corporate spine because I have a to go on a live stream here in a minute. Sure. But just share with the listeners and viewers of the Medical Truth Podcast short closing on your book, corporate Spine where they could buy, purchase the book, and

Dr. Ardavan Aslie: 42:48

in, yes, you can purchase it on Amazon, and it’s a good book because the first four chapters are to try to teach my patients what I’ve learned treating patients for 20 years through stories of my patients. I didn’t want it to be just a book complaining about the matters. So the first four chapters, I’m trying to teach the patient what we go through, what’s our view of things when we see and evaluate the patients, so they can understand, for example, why they go to five surgeons and they, Come up with five different recommendations. So the patients at least have some sort of an understanding of what’s going on in the world of

James Egidio: 43:24

spine surgery. And that is on Amazon. I know you have, I think it’s almost five out of five reviews so far based on the reviews and and it’s written for specifically for patients, so it’s not written, it’s an easy to read book, correct?

Dr. Ardavan Aslie: 43:41

Correct. It’s written for patients because I truly believe spine surgeons haven’t done themselves a favor, try to teach the public what we cannot do. Everybody has the expectation of going in, getting one surgeon, be all fixed up. That’s sometimes. possible. Sometimes that’s not the goal. The goal is to so the patients need to understand what they’re dealing with. And that comes from knowledge. And we haven’t done that. This book is the first time that we try to make the patients understand what we’re dealing with. Yeah,

James Egidio: 44:15

Dr. Asick, thank you so much for joining me on this episode of medical truth podcast. I really appreciate it I appreciate the information you’re putting out there and keep up the good work. I you know, It’s we got to get the word out there on these kinds of things. Thank you. We sure much. Thank you so much. Have a good day. All right

44:34

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