Hello ladies and gents Robert Sykes ketose, a.com to Dev. Get special guest dr. Art oven as Leon the Lion. He is a specialist when it comes to orthopedic surgery, especially as it relates to the spine. This is something that I know very little about it, but I know several people that have had to have spinal surgeries due to lifting incidents or car accidents or something of that
nature. So really diving deeper into what the current standard of care is with regard to spinal surgery, the fusion aspect of it. Why that may not be optimal or likely isn't optimal and then some some possible reasons that that is the case why? That is a senator care. And then some possible solutions. All this was very interesting to me. I learned a ton, I've got no note, no doubt that you will take something from it so that for their do sit back, relax and do a podcast with dr.
As Lee And we are live dr. Art of an Ashley. How are you sir? Doing good. Thank you very much. Thanks for having me. Yeah, I'm excited to have you. So I've I don't know what ton about proper spinal, health and surgery. But I know I think many of the listeners know somebody that has had their Fusion at some point they've had operations done to them at some point.
I feel like you are definitely a disrupter in this field so I love to kind of dive deeper into your area of expertise and what you're trying to do as it relates to surgery when it comes to the spying stuff. Like this is something that is often times a very misunderstood topic. Correct. And that's why I actually I wrote a book about what we do because, you know, quite
truthfully. I actually 20 years of practice or somehow become numb about this that my patients come to my office and they ask, you know, would be discussed surgery, they immediately turn around and say, oh, we heard that it doesn't
work. Or will be told by our friends that if they talk about certain don't accept it and And you know, the first five years of my practice, I used to not bother me but I'm like, okay, I heard this before and then I became numb to it. And then the last five years, I said, I have to do something about that because that's not fair to spice it. I don't think spine surgeons really have done a favour for themselves. Try to teach the public, what we do as spices, and what we have
available to us, what? We don't. So I wrote a book about spine, Surgery and this book is actually to section. I didn't want well, one thing is that, you know, I do research and development are very active in research and development. In Austria, product vertebrae, you know, early on, in my practice, I realized that we have a very bad problem, the world of spine surgery, facing aging population, do you know anything about spine surgery?
In terms of what we usually? I go back and explain what we do or yeah, that'd be great. Give the listener some context as to what the current standard of care is sure. So the majority of the surgeries that we do is a surgery called fusion surgery. So what happens is that the spine is bunch of bones that are stacked up on top of each other. We call them vertebrae and they are separated from each other. By this cartridge, we call it disc.
And this disc is a Complex structure we have because it has multiple function. It has to allow motion at the same time, it has to hold the two bones together. So not only has to pull them together, but it has to allow motion. So it's actually function is very complex. Well, what happens is that sometimes they get injured, you know, it's basically literally looks like a tire. So the inside is a jelly material. They Mushi gelatinous material.
That works like a shock absorber and You have a big thick fiber around that so it's like a jelly doughnut. Basically, the way I explain it. So if Integrity is very important to hold it together, sometimes I tell my patients, like a tire, but instead of holding are holding this gelatinous stuff. Well, sometimes if this disc gets exposed to increased stress, like a falling down stairs or you know, get into a car accident. Well, those tough fibers gets disrupted.
That happens the gelatinous stuff in the middle starts seeping out and just becomes painful. The good thing is that the majority of the time actually dis does not end up in pain. Actually patients, you know, they get into a car accident, they hurt for a couple of days or maybe a couple of months and then paying does go away and that's like 80 90 % of patients but sometimes it doesn't. So this pain becomes chronic and their needs treatments.
So So to treat that, of course, we do not what we call. Non-operative treatment, the way I explained to my patient treatment of back then falls into three stages. The first stage is what we call the manipulative treatment. The whole idea is to manipulate the body, try to get them better, that category, have physical therapy, Chiropractic Care, massage, yoga, you name it. It's a whole world. Second stage are therapeutic
injections. And most of those medicines involved injection of His own in different locations of the spine, why cortisone cortisone is an anti-inflammatory the way I explain to my patients is that and that's a very important concept for them to understand. It took me 15 years to understand it. It's not the damage that causes the pain is the body's attempt to repair the damage that causes the pain, which is inflammation. Basically. So if you have inflammation, you have pain.
If you don't have an implementation that Porn that damage. This does not cause pain. So the whole goal is to decrease inflammation and we do that by injecting cortisone which is an anti-inflammatory medicine problem with cortisone, is that it has everything in life has good has comes with negatives as well. So the good is that it can get a little pain.
The bad is that is very unpredictable so it acts more like a hormone as opposed to medicine and that's a very important Concert. I want my patients to understand it medicine. You know, exactly what's going to do at pain medicine, a blood pressure medicine.
It, you injected you see the effect but the problem is that in six hours gets washed off, the system will cortisone is kind of a unpredictable in terms of what's going to do and what's not going to do. But at the same time, has the power to eliminate the problem and that's why we use. So sometimes my patient asking we heard, it's temporary her Don't work and I tell him all of the above.
Yes, that can happen. But at the same time, one third of the time it eliminates paint and that's why we use it. So, the problem is we have nothing else. There is no medicine throughout my career, I've tried different medicines and just you know, every time I have a success in followed by total not know success, so there's really no medicine. So once we. Okay, so now once we try these things and page, Does not get
better. Then the patient needs to make a decision based on how much pain they have or how much pain they can tolerate. I always tell my patients, if you can live with the pain, don't get the surgery. But if the pain is so bad that you can't live like that, then we have to do the surgery. You know, of course, surgery just kind of brush brush up on it quickly. Surgery has a lot of risks like, you know, infection nerve damage. You know, and all that, all the
bad stuff. So my page, Agents always question asked questions about concerns about the surgery. What's going to happen on the other end? This is what I tell them. I tell them that look it all comes down to this. If you can live with the pain live with the pain, don't get the surgery.
But if it comes to a point that you can't live like this, then we're going to have to do the surgery and what comes after it is what it is. And of course, in my book I've explained all of this in more detail. So let's say you have a, we have a patient. Don't, you know, we've identify a problem on the MRI list which is a torn disc, torn cartilage. We've tried all these non-operative care didn't get better. Now, patient decides to do surgery.
Well, the surgeon that we have available to that is what we call fusion surgery. So, the surgeries to remove the damaged disc, put a spacer in there, and they're in the two bones into one bone. Well, we started doing these surgeries right around 1960s and 70s. And we thought that, oh my God, we do have some problem with this. Why? Because it good chunk of the patient's, let's say 30%, they did not heal. So you do the surgery.
You hoping that the patient is, you know what you do in surgery, you get down to the bone, you make the bone raw, so you strip it of all the soft tissue and you put. Put bone graft between the two bones and you close it. And you hoping that within the next four or five months, this bone graft will turn into a solid bone. Therefore, diffusion heels. And the two bones become one
bone. Well, unfortunately, one third the patient that didn't happen and what we call that in non-union, so didn't feel well in that situation. Now the patient has had pain, has had surgery and didn't feel it. Now, they're in more pain.
Actually, so what's the question, what's the answer for this problem, to increase diffusion rate, right around 70s and 80s spine surgery, being a subspecialty of orthopedic surgery, we looked at orthopedic surgery, we knew that when we treat it fractures like long, bone fracture, like you will femur fracture tibia fracture arm fracture. The best way of feeling this phone. Phone was a technique called rigid fixation, so a team in
Germany right around 1960s. Came up with this idea that you can dissect down to the bone, expose the bone, put a plate that's secured by screws into the bone. And basically did hold the factor ends in a rigid fashion, all the next to each other. So the two bones can grow into each other and the two fractured bones. Become heel, and the bone reconstitute itself. We call the rigid fixation, we call the AO technique. I think the word is a German, word Unger Cerro Castillo
synthetica. We call the AO techniques oao technique from Orthopedic fracture fixation, which is a concept of rigid fixation. We knew that worked very well in a trauma. So we said, okay, well, we know how to put the bone together or heal the wound together with Apply that concept to spinal fusions and to that we came up with a very large screws. We call pedicle screw and that's
where the Story begins right around. 19 mid-80s 8, 1985 two surgeons in France. They came up with a very large screw that they can insert into the vertebrae from the back, from the back to the front. So they put these two screws one on each side. Into the vertebrae like shish kebab and basically imagine how long I've heard her baby sheesh. I said where's that? How long are these screws like couple inches? No, they're all about yes. Four inches, 3 inches. That's quite a screw.
Yeah, right. So, did very large Scooby thick, so it's about six millimeters in diameter and very long screws. It is a big screw that gets inserted from back to the front, one on each sides and then these schools Who's on the other end, they have a tulip that can accept a rod. So what you do, you insert as many screws that you need in different vertebrae. And then you put a rod and you connect two screws on each side to A rod. So there will be one rod on one side and the rod on the other
side. And you have like let's say you want to fuse five bones, you put 5 screws in each side and then connect them. So you have five? If you have ten screws, two on each vertebrae and two rods and side. So that's how you do the surgery. Okay, so you follow me so far, right? So, when these became available in nineteen, these two surgeons came in 1985 presented, this to the American Academy of orthopedic surgery and the surgeons were very happy like, uh-huh.
This is what we've been waiting for. Somebody somehow somebody figure out how to put the screw into the The vertebrae. And that's very familiar with what we do in Factor. That's what was so familiar with what we learn in orthopedic surgery. So let's start doing them. So starting mid-80s people surgeons, orthopedic surgeon, starting inserting new schools, problem is at that time, there were very bad results. Initially, there were up to 7,000 lawsuits.
So, the lawyers, right? So lawyers not only should the doctors but they actually, Not only sue the manufacturer which was a company called Medtronic and actually this suit, the doctors and their society. So the lawyers soon manufacturer and suit, American Academy of orthopedic surgeons. It was about five hundred lawsuits against American, Academy of orthopedic surgeons and there were about five hundred lawsuits against North American Science Society.
So right around 90s the Whole Decade of 90s was a very very painful dickhead course, Spine surgeons because they have to deal with these questions. What we're doing the lawsuits, the results and everything. Actually, this stuff that I'm saying, I got it all from Google at that time, there was multiple investigations by United States Senate into this specific topic. And this is what happened right? At 1993, a surgeon called dr. Thomas is dead. Published a paper published the
paper. He's the chairman of University of Wisconsin, Department of science surgery. This paper was published by him only and this paper stated that. These screws work beautifully. They increased Fusion rate, they improve outcome and the numbers that they improve was very significant. So this paper showed that, the
screws are wonderful. Once that got published in Spine Journal in 1993, gave the green light for spine, surgeons to use at these pedicle screws and pedicle screws became standard of care in spinal fusions that he have some time. So you follow me. Yeah. That he have some type of tested interest in that going over so well. Like was he invest in somehow down the line? Wait, that's that's where. That's where I'm going to talk about next week is really
interesting. So what happens is that right around late 1990s like to 1998, 2002 five? No, I'm sorry. Six papers came out. Multinational multicenter said that the screws don't work, they do not increase Fusion rate to do not improve. So, what is going on? Well, these newspapers, they all got brushed under the rug and we just ignore them. We came up with excuse, or they didn't do this in this study. They didn't think that in that study and we said, okay, we
don't care. So we picked on that study 1992. We said we care about that study because the results were actually into what they wanted to wanted to. Basically, so so bye. Bye. Lets Say by year 2000, all those lawsuits have gone away. So those lawsuits basically went away by 1998 because of lack of evidence and by year 2000 nobody was questioning the screws. Every time you got a fusion surgery you put the screws in all that then there I come right around 2013 that I was working
on this. Device, my device. So what happens is that I wanted to come up with a device that is looks for. I mean helps I'm going to come back to that question that you said, but let me just say how. So, right around 2013, I was working on a device because I had realized that elderly population. We have a very serious problem. Why? Because these schools get inserted into the vertebrae. What does that mean? Well, the vertebrae Composed of two different bones. It's not just the Block, it's
not solid block of concrete. Let's say it's not like a solid block of wood and vertebral bone is like a shoe box. Inside bone is a spongy bone. What we call cancellous, Bone and outside, shell is a strong born. We called cortical. So, when these screws get inserted into the vertebrae, they'd get their purchase from
this spongy, cancellous bone. Lee. So what happens is that when we when the patient's age increase, let's say 65 plus seventy plus when the osteoporosis starts setting in osteoporosis affects the spongy bone a lot more than cancellous bone I mean to a significant factor. So basically when we get osteoporosis when the people get osteoporosis is the inside wound that melts away and outside shell stays actually pretty decent.
When I started working on my device, my idea was that we should come up with a device that use it outside bone as opposed to insightful. So, I invented this device, that is a flat plate that sits against the lamina. Lamina is a part of the vertebrae that is a cortical bone. It's very solid. I wish I had the pictures, I could show you like, what I talked about, but it's all written in my book. I talk about anatomy and all that stuff to teach.
The public and act out of me first and then, everything else lamina is a cortical bone. So my device would use a flat plate that sits against the lamina and use this composite straps to wrap, around the laminar there for, like a zip tie and cinches down. Therefore uses cortical bone as opposed to spongy. Well, and then the flat plate had. It had a little base that has a tulip, then you can put just, like, pedicle screws, you can
put as many as you. On the vertebrae and then cinch it down to the laminar and then you can put a rod to just like the rotary. So anyway, so my device actually won't be Novation Showcase in Congress of neurological surgeons in 2015. So it got presented to the Neurosurgical commune. So I'm Legit, you know, I'm not just talking the talk here. So what happened after? Well, it didn't happen over a year or two, it happened over
five years. As I was device, as I was developing my device, I hit some problems. I said, well, let me take a look and see how they solve this problem in the school. So I started going back and study the screws in more critical eye and more in detail. And what I found out was scary, this is what happened. I looked at all the Literature and I found I found the same problems that I was facing. It was present in the screws as
well. But nobody talked about, I was like, wait a minute, why nobody talking about this thing? Let me see what's going on. So, one thing led to another, and then another, and then another, and then I was like, oh my God, what's going on? And this is what happened. I looked at the literature about the schools and I found that oh my God, all these papers say that it doesn't work. What is going on? Did I said, okay, there's one paper said, that's what, let's look at that paper and dissect
that. See what's going on? Now, I'm going back to the question that you asked doctors Deb. Look in 1993. First thing about that study, is that that study was never finished. It, got published in 1993 as a preliminary report. I spent about two years to look and see where this final report is, and I Couldn't eventually I was talking to one of the professors from one of the midwestern universities and I said hey what's the deal with that paper? Where's the fine goes?
All that paper was never finished. It was abandoned in the middle. So I'm like, see that again? See what it was. Yeah, that preliminary report that you see, that's the only thing that we have. I was like my jaw drop. I was like, wait a minute, some of these papers, this six papers that came out. Some of them won awards like they were, they were, they want like Waldo. Wardrober award was given two lectures to do research that they've done. Some people that body is like a Nobel Prize.
I guess, they determine if a study was done, very good and complete and they give them the war. Some of those studies that said, these schools don't work won awards. I'm like, wait a minute. What's going on here? These studies downward Award with A passing through we totally ignore him. And in this study was that was never finished as a preliminary report becomes the sole anchor for the whole specialty. I got to do a little bit more digging here.
I gotta find out what's going on with doctors a doubler. Didn't? This is what I found out back to you. The thing that you just told me starting in 1997, it start. So he published a paper, 1993, starting in. 97 as those lawsuits were disappearing. He started getting paid from the company that was manufacturing. Those screws and was being soon. So as those lawsuits were disappearing because of this paper, he started getting paid. They're saying now. Of course I cannot accuse
anybody. That's that's not what it's all about. But what happens like they said that although he was getting paid for some devices that he invented and I've seen in Brazil, Inventions. It's really I don't know. It's no different than other inventions. Let's go this way. So between 1997 to 2005 he got paid thirty four million dollars to see that companies behind Okay so 34 million dollars was like, wait, just when you think things can't get worse.
It got even worse. So in 2005 Medtronic, put him in charge of another very important study. We put them on the study of a product called BMP. Bone morphogenic protein, one. Morphogenic protein is a product that is, that is a substitute to bone graft. You remember in the beginning of my lecture? I said, we could bone graft between the two vertebrae. So you turn into a solid bone. Well, you have to get that bone
graft from somewhere. Most of the times, we get it from our hip iliac joint, you know, iliac bone, like the hip bone. Well, what happens? It's like when you go Harvest that you hack out, that bone out, that area starts hurting. So we knew that we have to have an alternative for bone graft. Well, this product bone morphogenic protein, which is a hormone that we all have.
When you break your bone, you exclude, that hormone gets excreted and then bone heals, so they have isolate, they have identified and have isolated, and comes as a product, they called BMP. So anyway, so that was another big product. That Medtronic brought into the world of spine surgery, so they put doctors and devil in charge of that study this time in 2005. Doctors deadly got caught,
modifying his results. And that's not by me or it wasn't by some like Wall Street Journal or Boston Globe or anything like that. It was determined by United States Senate. So United States Senate, either investigation for that study in 2005 study for BMP and it was the United States Senate. That concluded that that paper that was published in 2005 was Not written by doctors oblique, but was written by the company. Can't you see that crazy?
What? Got this tune in to start looking that direction the first Passover? They're pretty suspicious at the answer. Correct. There were some allegations. Actually, I think one of the employees had a falling out with the company and he blew the whistle and he said, hey this is what this company is doing is just having Financial. You're basically buying out sign sir. You know, just give them, you know, stock options paying them,
you know. Because you can You can you can pay your surgeon or you can pay somebody with different Oil. We're not paying for this, we're paying for this but doesn't matter. You pay them anyways. You know, you understand what I'm saying? So you can say oh, you pay them for this a your research you did, or he paid him for some studies that we work for us. You'll never say that we paid him because he saved our bacon because all those losses, they'll never see that, you
know? And I don't know how much I can't say or I cannot say in this podcast but I can never Use somebody of doing something wrong but you just put the two and two together and this is available to every way anybody can Google it and this is all in there. This is I don't have some private investigator to find these out for me. All I did is just went to Google and start just punching him, some names, like doctors the devil lick. It all comes out, it's all in
there. So how so is he, how is he by passing on those lawsuits? That when he came out with that paper, 1993 and these companies started manufacturing these, these Screws, what did he do to make those lawsuits disappear? Well, I don't know. So I cannot I cannot say anything because then I can get potentially suit I guess for defamation that. But all I can tell you is that he published a paper saying that this stuff works. I mean that's a huge evidence you know because you understand
what I'm saying. So so we are using those screws, their results are not good. We're getting, you know, the door getting sued and then he publishes a paper saying that, this this stuff works great. What else do you need? That's yeah, that's what you need. You know. That's that's you could have done anything more valuable. Let's put it this way. So did anything happen retroactively? Sure, he got caught red-handed with the the bmp-2.
They go back retroactively and look at anything other than in the other things he's done or no. No no. So this is this is what the situation is. So I have to put two and two together. I mean it took me about five years to put the two and two together didn't come like one moment that I have like, oh my God. So I had to think about this I was like, what is going? Going on. What the heck is going on? Is this like we have just us spine surgeons, we have sold our
souls to these companies. Is that what's going on? Or we Crooks, this is what happens, you go to medical school, you go to Residents, you become a surgeon, you become a crook, I mean what is going on? And that's when it came to me and you came to me over to stand up three years. This is what basically comes down to us as spine surgeons.
We become orthopedic surgeons first, we study five years of fracture fixation and a and the principles affects your position which works very well, is what we call rigid fixation, you put the bones together in a rigid fash. Well, when the 80s come around and we have these problems in spinal fusions and he screws come out, the screws are the principles of use of screws are very in line with what we learn
in orthopedic surgery. So we applied the same exact principles of fracture fixation to spinal fusions accept that I figured out I found out in the summer between 2015 and 2019 like literally instead of four years that we should have never done that, you know, spine is a completely different animal and I'll explain to you why I always tell spine surgeons that I get into arguments with they want to tear me apart every time I question the spine surgeons, my colleagues, my friends about
that pay, wait a minute, there are all these paper say it doesn't work, maybe we should look into this and they want to tear me apart and I'm not talking about being agent up, some company know, they just want to tear me apart because they are absolutely believe. That's the right way to do it. That's the, that's the way. Why we should do it. And I had to answer that, why? Well, that's why, because we apply those principles to. So now I expect, I tried to
explain this way. I tried to explain me. Say look, the concept of rigid succession Works in their extremity, like arms and legs fractures because of one important factor. If there is a construct, let's say you put two screws and rods of you put the bones together and you think like hey man, look this concert is not Be strong. Then you have the option of eliminating gravity so you can
eliminate gravity in the arm. Of course you can put in a slick in the leg, you put them on crutches and you put them in a cast, you put them on crutches and you eliminate gravity. Well, in spine, you can't eliminate gravity. I mean, to eliminate gravity, you have to suspend the patient in the air or or laying down for like four months at a time. You can't eliminate gravity. So Do you have to, do you
principles, have to change. So what, rigid fixation worked in spine, is not going to work because the second you get up the second, you stand up that construct is under tremendous amount of stress. So, what you have to do is no different than building, a building, making a building a building in a construction zone. I mean, in an earthquake zone in San Francisco. When you build a building you don't make it stiff, you make it flexible, you put her On
rollers. So if there's a crate that doesn't doesn't just fall down, same concept, should be applied to spine you and I ride, and I explained in my book. Is that renewed new, we need new Goodbye says that I called reactive rigid fixation not flexible not rigid but reactive rigid fixation is something that if something happens to the patient, let's say they fall down, they get up and they do something. This doesn't like tear up the bone cut through the bone and everything fail.
It got to be a device that actually can absorb that energy. It can deform and then go back to its original form. So dissipate That energy. Do you follow me? Yeah. Yeah, that makes sense. And makes sense to rot be using like, like attach it on the surface of the bone that harder bone to like the idea of putting a screw into a bone in which case the interior is soft, makes no sense. It's kind of like putting a put a screw in the wall, in the sheet, rock without using a
sheetrock. Screw it just going to fall out after over time. Exactly. But that's half of the concept. The other concept is that that device had to be a little bit flexible. So when patient falls down or something bad happens, Like, there's an increase in the stress. It can give a little and it doesn't just tear away, right? And as the second concept, right?
So that rigid fixation, that we use in orthopedic surgery, applied it to spy, it doesn't work in spine because spine is under constant stress constant, you know, flexion-extension, you know, basically constant work because you can't put the patient, you can't suspend in the air. So I was like, oh my God, that's That's what's going on.
Then I looked back then, that's when I look back and I say, oh my God, that thing that they did that the Senate did investigation 2005 and nothing came off of it because they didn't know what are the implications. So then I come and say, like, wait a minute that 2005 has a great implications, why? Because it says that the paper that was published in 1993, Probably was bogus. You understand? So that means that to this day, we don't have any proof saying that these schools work.
As a matter of fact, all the study says that they do not work. So what does it come down to basically? So what I'm trying to say is this The whole training needs to change for spine, surgery from the beginning, we got it wrong from the beginning, we as orthopedic surgeons, we learned everything orthopedic surgery and apply dispensary, that should not never happen. We studied five years in orthopedic surgery in that five years, our exposure to spine is very minimal.
Then we do one year of spine, surgery, and then become spine, surgeons. And we have to do this complex in spine. Surgery is much more complex than orthopedic surgery, so the training is completely inadequate. So this what I say is not even controversial, it's so sad has such a huge implications that I'm calling for the whole thing. To be revised and we have to do that first by asking some serious questions and those questions are. Why was that paper in 1993?
Why was it published as a preliminary report? What was happening in 1993 that doctors biblic got published that changed the entire course of spine surgery, what was happening there? Why was it? Why was it preliminary? Why was it never finished what happened there when he started getting paid. Why was he? What was the reason that he started? Getting paid this much money, of course. And then when he gets caught in 2005, that automatically Brings into question, actually
discredits that paper. So we have to as a specialty we have to restart and we have to fix something that we didn't fix. And we just brush it under the carpet and I and my professors, my colleague gets so mad at me. When I say this, I see look, we went through a lot of pain in. 1990s, a lot of paint, those lawsuits and everything and they just don't want to open those wounds. They're like, oh my God, we went through a lot.
You want to open reopen those? And I'm like well because there was a good reason those wounds existed and we didn't address it. We just brush it under the carpet and kept going well, guess what? You can't do that. That's going to that. That's going to show its ugly head, sometimes down the road anyways. Yeah, I would imagine rerouting the ship, so to speak with regard to all orthopedic surgeons out there and pretty unwieldy task for sure.
I mean, are you getting, are you gaining much momentum at all? After you getting any people and your colleagues that are receptive to this, or they all pretty much pushing back in fear of rock on the boat? Well, that's a very important question. I don't know the right answer, but this is what I know world of spine. Surgery is divided into halves. One is the orthopedic surgery. What are the surgeons that became Spicer into the route of
orthopedic surgery? The other is the newer surface so they become neurosurgeons first and then they become spine surgeons now. Now, this is just crazy when I talk to neurosurgeons about this, they're very receptive. As a matter of fact, my device got wounded Innovation Showcase in Congress of neurological surgery which are the
neurosurgeons brain surgeons. When I talk about this concept to orthopedic surgeons, they just don't want to accept that anything other than screw is the answer for Damn. It gets hammered. I mean I want to be the surgeon. I can tell you right now 25 years it gets hammered into our head that the answer to any problem is a screw If you come up with anything but a screw, they just don't want to accept it. They just dots, just not it.
But when I talked to neurosurgeons, they're very open to this, and they actually agree with me. So that's why I sometimes I wrote it in my book saying, like it almost to a point that if you are an orthopedic surgeon, you have to unlearn what you learned in orthopedic surgery and relearn What is actually appropriate for spine, surgery. Isn't that crazy? That is that is is there any type of financial implication that comes with? Or I guess incentive for doctors and surgeons to use the pedicle
screws? Now like as there any type of Kickback for them for using those screws? Well I don't want to get into that because you know truthfully I don't want to incriminate my own Chi, you know? I mean I would like to say Yes, there is of course there is, you know, and that's one of the reasons that they're not receptive to my idea. And what I'm saying, because it's rocking the boat and that means that, you know.
Well, you know, it is what it is, you know, I always tell people, I say, you know, to solve a problem, you have to, you have to confront it head-on, otherwise you can't solve it. So, if it's something that, you know, you put it under the rug and stuff, you're not going. Be able to solve it. So I tell you my story. Actually, when I wrote this book, I wrote it very politically correct. In terms of not incriminating, people or companies and being very politically, and clicked and Mild.
Well, guess what? In 2020? So 2020, I got to call me, they almost died. I was in ICU for about eight days. And, and when I say this to my to, my wife, sometimes gets Upset. But I'm like, but you know what? It is what it is. I'm the man that always tell the truth. If the truth is not something that you like, you know, there's nothing new about that. So I tell my wife, I said, when I was dying, when I was just like, I thought that man, I can die.
Actually, because my proximal saturation was like 80% on maximum oxygen, you can give me. I like, 95% of my lungs just shut down. I was, you know, one of my friends who was taking care of me, who was it pulmonologists Rich respected? Fact, after I got out, he said I gave you one night 50/50, I really thought I might lose you.
So anyways, so when I got the call that I almost died, I became Fearless. I just said, because I got the second lease of life and I came out and I reload my entire book. And this time, I, you know, I tackled the problem head on because this stuff needs to come out, and if it doesn't come out then it's just going to continue in a Wrong direction. So same back to financial interest.
Yes, absolutely. Yeah. You know, it's very chic in my world needs dates that you know because uh spine surgeons were very successful students. You know, we were successful in our undergrad, with the task with residency and all that stuff. So what you finish once you finish there's no test there's no you know observation or anything like that. So you kind of a crave that At success still, you know, you can't just just be like successful better than nothing.
You know. It's almost like an NFL player that retires, you know, all of a sudden nothingness you know. So what happens is that to continue? That success the way that you measure success these days for somebody as fine surgeon. That's, you know, out of their training is that you become a consultant to a company. So when I go to these lectures, lot of these professors say, hey, I'm a consultant to this. Consultant that is almost like, your, your, your success. You know, it's like Chic.
It's like cool that you're a consultant. Well, guess what happens when you become a consultant? These consultant never write papers that says, hey, this product doesn't work. Nine out of ten or I don't know what's normal. Now, I don't want to incriminate all my colleagues in your because a good chunk of my colleagues are with me, they're saying the exact same thing saying that, you know, Well, let me, let me, let us go back to the question that you asked. Do I have people that I agree
with me? Absolutely. We have a journal called spine spine. Is are you know Bible? That's know. We reached find everybody. Reach Spine Journal in 2020. I walked into my office and the lead article caught my attention. This is exactly what the lead article said this. Is what it said, it said. Conflict of interest in Spine Journal is very common. What does that mean? Conflict of interest in spine?
Literature is very common. That's just saying that our literature is Tainted. I mean, this is, this is so it's not me, I'm saying that this is this is what they're saying. So what does that mean? Well, that means that when you are a consultant you work with a company, your tendency is to publish papers that are favorable to do it that product.
Well, guess what happens? So these and it's always a very famous Professor. So, these companies befriend a sergeant and that surgeon starts writing papers that are favorable to the product. Well, 10 years Do we find out that product do the work? Nobody says anything and we could just continue to the next product. Well, my attitude in my book is wait a minute. You publish, this paper will come back here. We got to ask you some questions. It can't be just like, no ramification.
You just publish a paper and nobody can say anything. Wait, a minute, if you publish the paper that you put the patients in the wrong direction, making him get surgeries that they really Nene didn't need it or surgery was not going to work and you betrayed public Trust. There should be some consequences to that. Yeah, I mean that that just not not acceptable, so, so that's what happened.
Oh, not only that this CEOs. Let's say a medical company, this CEO of that company has one goal and one goal only to make money for that company. There's really no other gold, that's what their goal is. And so they go that route, they befriend the surgeon a public toilet. Yeah. Then ten years later when the Brenda Brenda product doesn't work there somewhere out there in south of France. They have retired with 50 million, whatever they did. Nobody can touch them.
Hmm. So we got to have something coming back. Up we come back here, we got to ask you some questions. Like what needs to be on the world of spine surgery right now? We got to ask these questions. What happened in 1992, if you open North American Spine, society's website right now. If you go to North American Spine Society website and you look on the section for recommendations in the recommendations to you screws, you find doctors a devilish 1993
paper as a reference. Really wait a minute. I went through very rigorous training in my medical school residency and my fellowship I presented papers that won't some awards and they got shut down with his professors. Not one time, not even one time and unfinished preliminary report got even presented. So here we are. As spine surgeons, we are accepting unfinished. Preliminary report as a sole anchor for our specialty. It's specialty of medicine. That's just that's just I don't
know that it's beyond crazy. To me. It defies logic. This is what happens. Now I'm not telling you that I just wrote the book or just I actually fight the fight. So I go to these conferences, I chase down so-called leaders of the field, I've on Bush them. Some of them they were so nasty to know that getaway kind of some of the professor's. I remember I went to them. I said I need just five minutes of your time. Just five minutes. I remember one Professor from
New York so just just get lost. Kind of a thing. I said, all I need is five minutes. No, and then he walked away, you know, so But but, of course, not all of them are like that. I always tell people is that 80% of the professor, or sweethearts, they're very receptive. I sit down. I talked to him and they might disagree with me and I said,
okay, no, that's fine. But that the more you get toward the top Echelon, the more, they are like, they don't want to listen to anybody, you know, just just the gear set in their ways in a way. So, so, so I Mirai. I try to coordinate these guys and talk. So this is what they tell me constantly. They say yes, we know that we haven't been able to show these schools work with research so far, but we will, that's okay. We know they work, we will in the future and I'm like, wait a
minute. Wait wait wait, wait, right here. Every time you fail, to show that something works. You've actually shown that, it didn't work. These two go hand-in-hand, they're not two separate events are not independent events. If you fail, to show that something work you just showed, it didn't work. So we have shown over and over that. It doesn't class when it comes to an implantable device. We are surgeons. We are implanting these devices. It's our duty, it's our duty.
duty to show that these work, we can't just keep going. And not only that you can't just break. Even you can't say hey there's one paper shows that it doesn't work. The other paper showed that it does work. Then for we're goodno for every paper that shows it doesn't work. We should have two papers showing that they work, right? But so far so far, all these evidence have been ignored and it all comes down to our training because according to the training That we've gone through.
We are doing the right thing. And that's the problem because in actuality were not doing the right thing. And the way I explain it is this, let's say Newtonian physics and quantum physics, Newtonian physics. If you want to build a house, you can use Newtonian physics but if you want to send a, if you want to build a laser or send a spaceship to mood, you can't use Newtonian physics. Unique, quantum physics. You have to learn a completely.
Lately different set of regulations rules and language and that's exactly what's happening in the world of spine surgery. We use what is good for Orthopedics, what works in Orthopedics and we somehow convinced that it works in spine surgery as well. But it's not. And that's what I'm trying to say. This is so amazing. You say, you know, hey how's this going on for a long time? This is what has happened. This I know, because I go to conferences for last 20 years twice a year.
I go to all these come, I know all these guys will give lectures and stuff somehow in. I don't know when exactly let's say in late 1990s or so. Some people got up and said, there's plenty of evidence that screw works then Two years later, the guys who listen to those lectures. They trust. Those guys say they got up and say, there's plenty of evidence that screws work, and then that thing just got propagated. So, every time I go to these lectures, people got, and that's what I believed.
And I said, okay, so I was like, for the longest time from 2002 when I got board-certified. I mean finished my training all the way to 2013-2015. I assumed that we've already passed that point. We already showed that schools work. Very great because this thing just got perpetuated amongst us, oh, there's a people get up in the display of evidence that shows that screws work. But in actuality, there is none. So he wasn't too.
Like I had to ask questions, I had to go actually, look at the literature, like, wait a minute, where's that evidence? That shows stuff works. There's none people get stuck in there there, Echo Chambers and their dogmatic thinking. It's hard to Hard To Break Free of that. And I feel like, like, You said I feel like as a whole, the vast majority of orthopedic surgeons Doctors medical professionals.
They all genuinely care and are doing thing for the right reason with the intention of helping people for the Long Haul. But I feel like, I don't know. Do you think the solution to this is going to come from the bottom up or from the top down? Because I feel like with something as big as you know, the, the mainstream organization of Western medicine, the insurance companies, like everybody's kind of in bed with
one another so to speak. And if you look at What it would take to steer the ship and totally reroute its course and switch from using the screws to something different, is that more realistic or is it more realistic that the general population that is faced with having to have spinal surgery, is going to just become aware of this issue and then make that known to the doctors that are performing these surgeries. And then opt out of using these screws when that time comes All
right, that's the question. What you just asked me? That's the question that I've been in my head for the last five years. And as a matter of fact, my wife didn't want me to write this book. She was like, you have a great career. I've been in practice for 20 years, I have a great practice. We had a comfortable life, you know, my wife is an attorney and you can only ruin it. And I told her I said, you don't understand. I can't sleep at nights.
I mean, I can sleep at nights. I can't live with myself. Once I found out this problem if I don't get it out or do something about it. So, I have done my part. In terms of going to these guys going to the ark. This is the problem. I tell him, I said, I and, you know, and you go to understand, this is very important for people who listen to this podcast to understand. I am not saying, Saying something that is I come up with it myself and because somebody told me well that's your idea,
that's your belief. I'm like it's not my blinker. So it's what's written in the literature. All I'm saying is that hey if maybe this literature is trying to tell us something we can't just keep going. I mean if you're going to keep going, why do research, why do I have to go twice a year? Get what we call? Emmys. Why why why, why do I get the? You know, I have to every 10 years I have to recertify. So, every 10 years I have to learn the latest and greatest,
you know, all that stuff. Why do I do that? Why do I go through that pain? If you're not going to listen to the research. So all I'm saying is that I'm not saying that I'm writing. If you want to hear something funny, Let me let me tell you exactly what I'm dealing with. This is a true story. This happened to me. It's not like I heard from somebody else or anything like that happen to me. So, 2016, I was in Boston in North American Science society and it was just 2016.
I was just starting to ask questions, so I was nowhere close to where I am right now. So in 2016 I was just starting out swimming question. So I I got up in the middle of the conference in front of 1100 spine surgeons. And I said, hey I know that all these papers are paper saying that these screws don't work. Maybe you know what do you guys
feel about that? Maybe we should address that issue and you know the professors that were sitting on the panel, they kind of a, you know, they kind of brushed it off or they didn't answer and stuff and I wanted to be confrontational. I don't every time I raise this, it's a fight. Every time I read this, not some arguments a fight with orthopedic surgeon, renewal surgeons. Yes, but with orthopedic surgeon, The fight. They just want to tear me apart.
So I didn't want to. I'm going to talk in about going against leaders of the field. These are my mentor. These are my, you know, people who I look up to. So that's very difficult for my point, my part to do that. So I but at that stage I didn't know what I know now. So I sat down and everything. Okay, so 20 minutes later session has ended. I'm getting coffee. So, as I'm getting coffee, I'm talking to a surgeon and he introduces me to the guy to the surgeon behind me.
And he turns around to him and says, oh doctor, as he doesn't like the screws. And the surgeon behind me said, oh, oh, you're the guy that says that thing about the screws? Well, I just want to tell you that everybody is entitled and welcome to their opinion, but I just want to say that you were very wrong. I said it's not the fact that I'm right or wrong. All I'm saying is that the research, the research says stuff doesn't I work, we can't
just keep on going like this. He said, I know I publish those papers, those are my patients. I'm like, yeah. What's your name? And I won't say the name, but he was a surgeon from another very far count from where I live, which I live in Sacramento. That's all I can tell you. He said, those are my patients. My name is this. I'm like, okay, I had the papers in my hand. I have. Okay, let's take a look at it. What's your name? Ok. So I found he was the second paper in my hand.
We'll see. That's my name. That's my name. These are my pictures. You was the Author as okay. Let's read your paper at the end. This is what it says work for work at this point. At this point, there is no evidence to use or recommendations not to use these screws on a routine basis, word for word. You look at it goes, you looked at it, you look at it again then said, no, that's not right. And you walked away his own paper, his name was on that paper, that's what I'm dealing
with. Wow, it's not crazy. Z that's in my book. It's like I was like, oh my God you know. So what I'm saying is that I have done my thing, I have talked to people and it's not going to happen from inside, for many reasons. One, I'm cutting all these hands that are feeding him. These guys are Consultants with each companies and I'm basically cutting off their sandwiches, what I'm saying? That's the one they can to they've done research.
Re I'm telling him that you've been doing everything wrong for the last 30 years. Nobody wants to accept that. Well, nobody wants to say it, but the research says it is your and they are aware of these paper. It's not like these papers are. I found them and nobody know, every spine surgeon that it's an academic world, they know these papers because these papers came out and very, you know, very top Journal Journal of sign that couple of the Paper guys, had
they won awards. They were published in sponge or they're very aware of it. So, I'm thinking, so, at this point, I didn't know what to do. I eventually was talking to somebody who said this is what's going on? He said, well, why don't you write a book? I'm like, well, I'm not a good writer. I can't who doesn't have to be very complex. It can be action, very simple. I said, I guess I will so that's
what it was like four years ago. That's when started writing the book and and I wrote the book for one purpose. Okay. If you're not going to listen to me then I'm going to go to the public. I'm going to let them know what's happening to them. Let them decide now what they want to do from here, this point on here I think that's best. I mean I think just putting the power in their hands and letting them vote with their dollars and their time and their interest. You know that's it that's
exactly. And, you know, and as I said, this is not something that I say, okay, we need to look at it. Dear has been to investigations By United States, then it into this. But at that time I don't think anybody knew what they were dealing with. I'm the first person that put it all together and say aha. This is what's happening, it's unfortunate. I feel like there's just, there's so much of what you're illustrating.
Now taking place within the nutritional circles that I'm running around in. I mean, people get so entrenched in their belief system that they totally remove any sense of open-mindedness. And then I think Pride also reared, its ugly head, people do things for so long. They're seen as a source of inspiration or source of
knowledge within a given field. They take pride in that. don't want to be wrong and then anybody that comes along that you know points to our pokes holes and what they're doing which I think is a good thing they just don't their pride won't allow them to be open and receptive to that and I feel like that it just it just stunts growth so much You know, that's it. What you just said? What you literally just said sums up the entire thing.
And there's a reason why I was the one that came up with this book, why? Because, I always tell myself, what if I'm wrong, what if I'm wrong, you know? And, you know, I'm kind of a person says, well, if I'm wrong, is not a big deal, I try, because I always tell people, I said, you get points for trying, you don't get points for being right or wrong. Wrong, you get points for trying. That's the most important thing. And that's exactly in work, especially in the world of
spicy. Let me explain to you something. When I first started, my practice I was trained by my professors, that nothing works. But surgery, physical therapy. We don't know what they're doing, car packing. Care is absolutely junk. Just don't even, you know, it's just worthless. So that's the attitude that I saw of my practice now. I started my practice in small town called Yuba City, kind of north of Sacramento and I was
the only spine surgeon there. So there were a lot of chiropractors that they want to befriend. Me and initially of my articles like oh my God, I don't want to talk to but then I one day I told myself, I said I'm a very open-minded person. I'm kind of a guy that I accept everything. So let me talk to these guys. Why am I, you know? And then when I talk to them, when I actually someone came to my office, showed what they do and I'm like, well, this actually sounds great.
And you know let me see and then it hit me. Hit me why? Well as spine surgeons all day we see people who had other treatments and they did not get better. Well we never see people who have those treatments and got better if they got better they're not going to come and see me.
So we are really skewed in terms of our perception and what we are exposed to and because of that, we develop our own Bias what works and that's why part of my book says that never ask a specialist, what they think of other Specialties why. Because always they have those, they see the people who have those treatments and didn't get better. If they had those treatment got better, they're not going to
come and see them. Hmm. And, and right and then and and then I always tell people that, you know, like for example, I have to defend chiropractors. In front of my other spine, surgeon friends because I have to defend spine surgery with my chiropractic friends, chiropractors in spine, surgeons think, chiropractic care doesn't work. Well guess what? Chiropractors think surgery doesn't work, and I have to tell him he's like no, no, if you get the surgery you're better.
You're not going to go see a chiropractor again the only those guys who are not better, they come back and get Chiropractic treatments. Mmm, so, so what I'm trying to tell you is that Learned as a spine surgeon and I explain to my book. I learned from everybody, I've learned so much from chiropractors, I learned from every single patient, that is, I learned from my own mom. So so that's what being open-minded that the teachers.
And because of that, I was able to learn really where this pain is coming from. What is the thing, how we can evaluate the patient correctly and all that stuff? And you are absolutely right. I mean what you said that people will not Bend and they believe in what they believe is the
downfall of our thing. I remember one time, one of these I was just talking about these screws to another friend of mine finds another spine surgeon and he turned around and says well okay what are we do this? What are we just get? Put the spine surgeons together in a room like in the conference and See what works. So we have like that's exactly how we got here. Yeah. No, for sure. I think you're doing it right by being open.
Like your I would imagine there's like mountains of red tape to jump through, but I'm assuming, there hasn't been any use case scenarios in which your device has been used in place of the screws thus far again, it's just too new.
No, this is the situation of course I keep saying back the book and all that I really I really I tell people, I said it's your duty it's not just like, hey read my book is a cool with no. It's your duty to read this book and you do need to let everybody else that you know to read the book and and you know and the treatment of back pain. I've said that you know, the red tape and All that stuff, that's hard, but we have to start from somewhere.
We have to do something. We can't just just sit back and do nothing not doing anything is the worst basically? Yeah, I agree. Well, it's definitely spread the word about your book, man. What's the name of it? Name of the book is Corporate spine, so it's to section the first, I didn't want to write a book to just complain about things, you know? So the first four chapters is about teaching people what we go through as fines.
June's to evaluate patients when we decide patient needs surgery or doesn't need surgery, or what type of surgery. So I teach spine surgery first and then the second part is how the corporations have taken over spine surgery and just driven it into a dead end. Let me tell you this, let me tell you, this is very important for people to understand. Spine surgery is at a dead end. What does that mean?
Once you Except once you dig in that the screw is as good as it gets and you're not even give the chance for any other product. That's it, you're done. I tell you that if he continued with that attitude, we're going to be doing the same exact surgery decades from now because we have accepted that the screw is as good as it gets and this is what I have to deal with. I mean they don't even give and off. Now, I'm not talking about of course all the surgeons. You know everybody who This is
to my podcast to this podcast. They need to understand that. I'm not saying everybody the same 80% of the surgeons, they're sweethearts, they're really nice. The problem is that top 10% the hierarchy. When you go up that pyramid, those top 10 person that sit on top. They are the problem and they're the ones that are most famous ones.
They're just like they did your, they have their own groups, they have this, the lumbar spine, Binary Society, circles my research society, and they have this attitude of a professors that you got to be one of us to be part of us so we can listen to you, I was like, wait a minute. If you're going to be part of you to listen to you to think like you do know that they're going to talk just like you and there's going to be no progress. Yeah.
Feel like this is often times the case in the medical field in academics in everything it seems and it's kind of morbid but it seems like the the vast majority of innovation is When those top-tier people honestly die off and it makes way for new generations with new ideas and open minds to come and fill that void. Correct, correct. Now this go back again, to What I Got sidestep by what I was saying, you asked me a question about my product, what's the
stage with that? This is what happened, this is what happened, I was at a medical conference. I was in, I think it was somewhere in San Diego, in American Academy of orthopedic surgeons, and I got up and I said the same thing about, you know, like the satisfaction of the screws. And they said, what are we do? And I talked about my device and then one of the surgeons as I have to be open about this, one of the surgeons said, well, all you're doing, you're just promoting your own device.
Well, I took that seriously, I took that to the horror. I said, you know, what am I like? Just I myself like, what are these guys? Except, you know, except just different attitude, you know, because last thing I wanted to do to become one of them. I always tell people I say you always complain about this and that but last thing you want to do to be one of them except just a Flavor, you know, you got to be careful. You don't get interested into that Loop, you know?
So I took it to the heart and I said, you know what? When I first started my research and development, my goal was monetary, my goal was to invent something that I can sell it off. And, you know, by myself, a vacation home down in Southern California, and maybe a nice car and stuff like that. Yes, that was my goal. And I'm not, you know, I'm not at the same time, you know? I'm not saying that I do everything for free now.
No, but the problem that I step into got too big, we're talking about a huge problem here and this is not a time to think about getting some vacation homes and stuff. So I told myself, I said, I have to stop developing that device. I have to stop it, so people. So my message doesn't get lost. That's so I stopped. I stopped all the development on that I said, I have to sacrifice myself to get the problem because we have to this is not about me getting some nice
house. This is not me by getting nice car. This involves a specialty of medicine. We're talking about everybody in this world that gets spine surgery. So I have to make sure that that my message goes on on tainted, you know, doesn't get people. Don't get we're off from that. So I said, I'm going to give up on that. Let's work on this and that's what happened with that.
I think that's super as I said no. Like, I feel like sharing that part of the story brings even more credibility to your message. I would definitely make sure that that is known. I mean you don't want to say things just for sake of, you know, that identification are. But I feel like that speaks volumes to your integrity and your motives and I feel like if people knew that, you know, then they would just buy in that much more. Correct. Corey exact. And that's why.
Because, because why? Because the problem is so big, you know? And and I have to sacrifice myself, you know. It's like, you know, you you have a great life, you're a document and then some War happens and you have to all of a sudden and that has happened and, you know, coming from Iran. I have lived that life that everything was great and all of a sudden, the whole thing comes apart, you know, and then all of a sudden you become a refugee and that's what happened with me.
I have Escape from Iran. So I have lived that life. I know how about works that you know hey you can have a great life but don't take it for granted you know things can fall apart very quickly and and that's what I felt that. Hey if I have a great life if I have this thing pay let's sacrifice it, you know and and because we have to fix this. So so you're right I mean I had to give up on that and End and I
have no problem with that. You know, because because because on the other hand, if I don't do it I can't get sleep at nights, right? Hey, I can't live with myself. No, I respect that for sure. When you're called to something for a higher purpose, than just your own personal gain and you see the benefit to the, you know, the larger population than
yourself. I mean that, and if that goes through, and if that gains moment, if you're able to truly change lives, like the Fulfillment that you'll get from, that will far Any monetary gain that you can get from anything else? Correct. Correct. Correct. I love it. I love it. Well, I will certainly do everything in my power to point people towards your book. What where else can people follow along and learn more about you and dive deeper?
I mean, the book says, quite a bit, I actually did a chapter one of the chapters about my life, where I came from, and what led to this because, you know, just coming out and saying the stuff, hey, You know, this is what I found this is, that's just, you know, there's opens a lot of questions like how, you know, how did you, how a surgeon in Sacramento, came up with this thing saying that, everything we've done so far is wrong, how
did you get about that? So I tell my story that how it started, you know, it was really a simple comment that changed my life, to be honest. And it's all in my book, one comment, one comments and by one surgeon just change entire my Higher life. And so they can, they can read the book and they see quite a bit about my story and then I made some videos I figured, you know, because I want this
message to get up everybody. So some people that they cannot read the book then I made a website that's going to be ready hopefully within the next week or so. So today is December 19 December 1922 into within a week or so we're going to have a website that I actually Every chapter of the book. I say it in person, I have a video that I explain every chapter.
So if you cannot read the book or you have you read the book and you're confused about some stuff, you can listen to those videos and then we'll just you can comment and I cannot answer the common. We just, I just don't have time, but I will definitely read the comments. Awesome. Well, I applaud what you're doing. I think it's, I think it's amazing. I think standing up in front of the adversity when you get in so much pushback from all over.
Your colleagues and everybody in the hierarchy of the medical space. I mean, I think that takes a lot of Courage. So by all means, keep fighting the good fight and keep doing exactly cute. Thank you. Well, thank you very much for your time, dr. Leslie, I really appreciate it. I've learned a ton and like I said if there's ever anything I can do to spread your message further by all means, please let me know. Absolutely, absolutely.
I very thankful to give me this opportunity to speak to you and your platform to spread the word about what's happening, really in the world of not just spine surgery. But in the world of medicine, you know, we need to go Buddy needs to be accountable for what they do. Simple as that. That's my message and 1000% a green and 1000% agree with. Thank you. So, very much for spreading that message. And you have a wonderful wonderful holiday season.
Merry Christmas to you. Merry Christmas to you too. Thank you.