Customer Reviews

Rehabilitation Protocols for Surgical and Nonsurgical Procedures: Lumbar Spine

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Rehabilitation Protocols for Surgical and Nonsurgical Procedures meets the challenge of providing techniques, as well as responding to the demand for accountability in the current dynamic healthcare environment. The research for the book has also tested the proposed spine protocols' acceptance among other spine practitioners in the East Texas region, and across the United States. During the past eight years, these protocols have been presented to many spine physicians and rehabilitation specialists to utilize and critique, the results of which are presented within these pages. McFarland and Burkhart have a combined experience of more than fifty years as physical therapy practitioners. Dr. Danielson, as well as the physicians at NeuroCare Network and the East Texas Neurologic Institute, has continued to support efforts in this area. These protocols have provided guidelines for referring surgical and nonsurgical patients for therapy, resulting in the development of a foundation for therapy experience that has generated new ideas for rehabilitation and care.
The American Back Society has contributed to this work as well, with the efforts of Executive Director Dr. Aubrey Swartz and current President Dr. Philip Greenman particularly instrumental. They have supported the development of these protocols since the early phases, extending the work throughout the ABS's worldwide membership through conferences and publications and sponsoring surveys for further research in the rehabilitation realm. Their combined efforts, Dr. Danielson's support, and the research of the authors have culminated with the publication of this book.

This book unfortunately is an accurate representation of how profoundly irresponsible is the field of spinal reabilitation physical therapy. The author should know that you can't correct for the blatantly bad medicine that many many spine surgeons practice. Almost in passing she states that many of the procedures performed by these surgeons are of questionable value, lacking any evidence based support. As an example, with over 300,000 spinal fusion surgeries performed a year in the US, each surgery costing from 30,000 to 50,000 dollars--well you do the math it comes to 9 to 15 billion dollars and that's just for one procedure- fusions- which lack scientific support. It would have made much more sense to write a book recounting the effects on the patients of these inexcusable and mostly scientifically unsupportable surgeries, along with appropriate PT protocols that can be used to optimise patient function and wellbeing. But then with that sort of a book she might have been out of a job. When will the physical therapy profession begin to refuse to remain under the control of a medical profession that understands little about physical therapy only paying lip service to its true value. For me the profession has alot of growing up to do with regards to refusing to participate in procedures that are mostly performed out of greed,ignorance to scientific best evidence, as well as disregard for the well being of the patients. On another note one could not even use this book as a manual for implementing rehab protocols, as much of the information presented was too vague to be of much practical value. So even if one accepts the premise that the procedures presented are preformed for scientifically surportable reasons, still the book fails to fulfill its title promise. I hope that these criticisms are taken with a positive view of how the world of spinal rehab could become. Sometimes it is better to state that the emperor has no clothes rather than participate in a corrupt and morally inexcusable system. Respectfully, George Fett,MD