You may have seen in the news last week that Tiger Woods announced an endorsement deal with the company Centinel Spine®, LLC, after attributing his comeback at the 83rd Masters to the spinal fusion surgery he had in April 2017. Woods underwent spinal fusion surgery using Centinel Spine’s Anterior Lumbar Interbody Fusion (ALIF) and their STALIF M-Ti™ fusion implant, and he credits his miraculous comeback after a long hiatus to this surgery. Given that Tiger Woods is one of the most winning professional athletes of all time, people are talking about it, and wondering if they should look into the same surgery for themselves. Celebrity endorsement of any kind of surgery concerns me and I feel the need to comment.
Tiger Woods has one of the longest lists of endorsement deals of any celebrity in history, including Gatorade, Taylor Made, and Nike, and if we look at this partnership through the same lens we might be reminded that big healthcare is also a business. This partnership will be a major profit generator for Centinal Spine, for Woods, and for the surgeons and facilities that offer this surgical technique and product. I worry that this partnership downplays the associated risks of fusion surgery and true expected long-term outcomes for the everyday person experiencing back pain symptoms. I urge you to do your research and advocate for yourself if you’re being told you need orthopedic surgery of any kind. Do not be tempted by the glamorous outcome of a professional athlete to drive decisions about what might be best for you.
Spine surgery is not a quick fix that will get you back into the game, and I commonly see people who have had spinal fusion and still have persistent pain and other problems associated with the surgery. In fact, studies have shown that patients experience the same pain 5 years out whether they pursued conservative care with physical therapy or spine surgery. Furthermore, studies show that there is an 80% chance Tiger Woods will eventually develop adjacent segment disease as a by-product of this fusion surgery. This is where the spine levels above and below the fusion are stressed causing degeneration resulting in additional pain. When this happens, the surgeon will likely recommend additional levels of fusion, and then the surgery story continues. Knowing these statistics, surgery should always be a last resort and patients should maximize all conservative care possible first. I typically do not recommend fusion surgery unless patients have profound numbness and weakness which signifies nerve damage. Most people can benefit from PRP into the spine as a conservative route before pointing to the last resort, which in this case was a spinal fusion procedure.
Interventional Orthopedics is a specialty which focuses on strengthening the spine to improve symptoms and function without the use of surgery, high-dose cortisone injections, or chronic pain medications. If you are confused on a what treatment is best for you, find a doctor who takes the time to get to know you and is willing to share the pros and cons of all the options that you have before you. I spend 60-90 minutes with all my new patients to ensure that they leave with the education they need to make the best decision for themselves. Some people actually do need to have surgery, as their condition is too severe for non-surgical interventions, but I cannot stress enough that this is not the case for most people. Before you go under the knife, advocate for yourself through education! I am making it my mission to help provide more resources so that you can have information at your fingertips to do just that.
Otoño Silva, M.D.