Dr. Johnson’s lecture on Spinal Stenosis to the Highland Park Senior Center

Posted On: June 29, 2013

This last spring I had a return appearance to lecture on spinal stenosis to the Highland Park Senior Center. I have given a similar lecture at the Lake Forest and Lake Bluff Senior Center as well as the Highland Park Senior Center in the past.

The lecture packed the room at the Highland Park Police Department with approximately 60 people in attendance. It was a very lively group of individuals many of whom had been patients of mine in the past.

The message of this lecture is very important and it is as follows:

1. Degenerative spinal stenosis is common
2. All lower back pain is not stenosis
3. Pain referring into extremities is key to the diagnosis
4. Imaging studies (MRI, CT etc.) will identify areas of stenosis
5. A positive imaging study for degenerative stenosis without referral into the extremities is not clinically important
6. There was 15 fold increase in complex fusion procedures in the Medicare population from 2002 to 2007
7. These procedures are no more effective than simpler spinal decompression procedures
8. There are more complications and deaths with complex fusion procedures when compared spinal decompression procedures
9. Costs for complex fusion procedures were 80,888.00 per patient vs. 23,724.00 for spinal decompression procedures
10. The evidence for the effectiveness of epidural injections is mixed at best
11. There is evidence that conservative care in the form of chiropractic flexion distraction and physical therapy is effective in helping two thirds of the patients with lumbar spinal stenosis with leg pain
12. Patients should fail at conservative care before considering surgery

My goal was to make the Medicare patients wary consumers of medical procedures with regards to symptomatic spinal stenosis. The Highland Park seniors were sharp and receptive. The overall response to my lecture was favorable and the attendees seemed to absorb the information I presented quite well. As both a chiropractic physician and a physical therapist, I feel that this message is very important from a public health perspective.

I know that I reached my audience because not only did some of them become patients at North Shore Spinal & Sports Rehabilitation, but I even got a call from Chicago by a woman asking where she could find good conservative care for her spinal stenosis. I was able to find her a chiropractic physician well versed in the management of spinal stenosis.

This was my most gratifying lecture on this topic to date, and I look forward to more of these engagements in the future so I can continue to spread this very important message.

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