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Consultation Express®

 
Consultation Express was first initiated in 1993 as a uncomplicated and low cost means of screening patients with spine problems in the same way that other screening programs such as tuberculosis and scoliosis  have been successfully used in the past.  The spine oriented Consultation Express service was intended for patients who have not had previous spine surgery because post-surgical patients require more sophisticated evaluations. 
The illustration to the left from the Congressional Budget Office (2007) tells the story regarding the explosion of health care costs in the United States.  After costs due to psychologic, psychiatric, and drug related disease are removed the treatment of back disorders is the number one health care cost.  It would also be the most controllable if some common sense was applied.  It has recently been shown that the most common reason for spine degeneration is genetic, not acquired as previously thought.
This means that early screening and prevention in this area could dramatically reduce the later costs of surgery and associated disability.

Brownlee has pointed out in her book "Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer" (Bloomsbury, 2007), that "practically every aspect of back pain, from the terminology to various treatments to he imaging tests, like MRIs and X-rays, used to diagnose it, is fraught with confusion and controversy".  This problem has been particularly apparent in the all-too frequent recommendation for multi-level  instrumented fusion surgery as a primary means of treating low back pain due primarily to genetic factors.

An inexpensive screening service such as Consultation Express is available to individuals but is best employed by organizations who recognize the advantage of preventive care. 

The Consultation Express service is now being provided by the Center for Restorative Spine Surgery in St. Paul MN.  It involves the filling out of a special questionnaire and submitting this along with a recent screening or standard MRI imaging study for review by an experienced and  qualified spine specialist.