Spine care, more specifically surgical spine care, and even more specifically surgical fusion spine care in the United States has represented for far too long, a primary example of a frequent lack of good clinical judgment.
The February 11, 2011 Wall Street Journal article titled: “Whether You Get Back Surgery May Hinge on Your ZIP Code” has been only one of many recent publications which have continued to document this sad situation.
Laura Landro, (March 28, 2011, Wall Street Journal) pointed out that the U.S. health care system has never been in greater need of innovation than the present time. With the 2010 passage of new health care legislation in the U.S. 32 million individuals are now expected to flood into a already reeling health-care system further stressing programs which are already spiraling out of control.It is therefore a refreshing task for Burton Report to focus attention on Phototherapy (primarily laser and superluminous diode low intensity light therapy) as something which is safe and cost-effective which can produce significant beneficial results in a number. of conditions. While just about everyone is familiar with high intensity lasers as used in space, industry, and medicine few know much about the world of Phototherapy.
The general credibility in regarding the healing powers of Low Intensity Light Therapy has suffered, as have many other therapies in their early days, from over-promotion and misrepresentation. One classic example of this phenomenon was the early application of electricity in attempting to treat all the ills of mankind. It has taken the dedicated effort of pioneers such as Canadian physician Fred Kahn to document out that there are appropriate and safe uses of Low Intensity Light Therapy. Dr. Kahn has now kindly shared some of his thoughts on this with Burton Report.
The science behind therapeutic (low) levels of light is its ability to enhance cellular regeneration resulting in accelerated healing. Molecules within the cell, and its membranes by absorbing different wavelengths of light. Therapeutic Low Intensity Laser Therapy has been consistently found to be most clinically effective at the Red (660nm) and Infrared (830 and 840 nm) light wavelengths. At this time there have now been more than 3,500 articles reviewing the benefits of phototherapy as well as over 200 double-blinded studies demonstrating its effectiveness in a host of therapeutic areas.
In December 2009 the British Journal “The Lancet” published a randomized and controlled study demonstrating significant benefit from the use of low intensity laser therapy in treating both acute and chronic neck pain (Chow, et al., The Lancet Vol 374, Issue 9705, 2009).
In the arena of “POEM” (Patient Oriented Evidence that Matters), a concept popularized by the British Medical Journal as a means of identifying highly useful information, the research behind phototherapy certainly takes a front seat from the standpoint of safety and efficacy..
The physical therapy and rehabilitation medicine journal Advance, Johnson (Vol. 22, No. 14, 28-29, 2011) has recently pointed out that there has been a dramatic increase in patients seeking alternative means for treating chronic pain and that phototherapy has offered “a non-invasive, safe, and effective way to meet this demand.”
As a past drug and device neurosurgical representative who has testified before the U.S. Congress regarding medial device legislation, as well as having been a past FDA Medical Device Panel Chairman, it has always been astonishing to this Editor that the FDA has never truly understood the true charge of such legislation initiated by the U.S. Congress. The Medical Device Amendments passed in 1976 were not to solely regulate medical devices but to also actually promote low cost, safe, and effective devices which would otherwise not be known or be available to patients. Now is most appropriate time for U.S. and Canadian Health authorities to begin to become more activist in innovating and promoting such important treatment modalities, of which phototherapy clearly represents, in the editor’s considered opinion, one of the more important of the innovative new alternative therapies having scientific merit.