Dr RD Guyer letter


April 16, 2008


Dr. RD Guyer

President, North American Spine Society


Dear Dr. Guyer:

After reading your 2007 Presidential Address in The Spine Journal, “The paradox in medicine today—exciting technology and economic challenges,” I have to both applaud you for your analysis of the dilemma facing spine surgeons, but as a doctor of chiropractic, I am curious about the fact that you failed to mention what the current literature now validates—the fact that most spine surgeries are now deemed unnecessary, ineffective, costly, based on a suspect disc theory, and that conservative care like spinal manipulative therapy has proven to be the initial treatment of choice for many cases.

Until this dilemma is addressed, spine care will remain paradoxical and ineffective for many patients. This omission surprises me since you are one of the founders of the Texas Back Institute. With your extensive background with multidisciplinary spinal care, I was shocked to see the complete omission of SMT and chiropractic care in your address.

Perhaps it was not appropriate to mention the dreaded “C” word to a roomful of spine surgeons, but if they want to find real solutions to the epidemic of spine ailments, your address would have been a great starting point to mention the work you’ve done at TBI. I’m certain Jay Triano who is a friend of mine would also appreciate your endorsement.

Your oversight, I believe, is attributed to the myopia that permeates spine care in America, a country that does more spine surgery than any other nation in the world. Perhaps it’s just too lucrative a market for you to mention that an alternative profession may be a cheaper and better mousetrap for most spinal problems we treat.

Remarkably, The Spine Journal (Volume 8, Issue 1, pp. 1-278, January-February 2008) also spoke of these revelations which apparently continue to fall on deaf ears. Indeed, it must stick in the craw of many MDs’ to hear notable researchers admit that those damn chiropractors were right all along. While DCs certainly don’t handle the serious spine conditions that surgeons face, we do treat successfully the majority of mechanical low back and neck problems as the research indicates.

I’ve included a rather lengthy response to your address that I will submit to The Spine Journal to support my contention if you’re so inclined to read it. I’d enjoy learning of your response as well.





JC Smith, MA, DC