Neurosurgeon Randal Peoples, M.D. spoke to a dozen claimants’ attorneys and interested health care providers recently about his philosophy in treating spinal injuries. He acknowledged that he has a reputation for being conservative about recommending surgery and stated that being a good surgeon is knowing when not to operate.
Dr. Peoples emphasized that the patient’s history about an injury is the most important information to him in diagnosing a spinal injury. About one third of the population has a disc herniation on a MRI, but most don’t know it and don’t have pain or disability. Dr. People told us that he first educates his patients on the anatomy of the spine in order to answer questions about what is causing the back or neck pain, how bad the injury is, and what can be done about it. He prefers to use steroids or ibuprofen initially to reduce inflammation with an acute injury, and he advocates allowing the body time to heal naturally without masking pain with narcotics. He also prefers McKenzie protocol therapy. Epidural injections at the right spot in the spine can be useful as a diagnostic tool for the surgeon when photos are taken showing the location of the injection.
Dr. Peoples gave us a detailed explanation of the difference between a disc herniation and a disc bulge. He also discussed that a more conservative treatment approach can be taken in treating the lumbar spine than the cervical spine because the spinal cord does not extend into the low back area. He thought that laser spine surgery advertisements can be very misleading.
Dr. Peoples talked about what he has learned from treating the acrobats and contortionists in the local Cirque du Soleil shows. While spinal injuries can be very painful, he emphasized just how resilient the body can be. He mentioned that about 1 in every 5 people has either 4 or 6 lumbar vertebrae instead of 5. He dislikes using the term “degenerative disc disease” for what is the normal aging process whereby our discs become more compact and less resilient as we get older.
Dr. Peoples impressed the group with his ability to communicate in understandable terms. I particularly like his treatment philosophy of not being too quick to rush into low back surgery. My clients who have treated with him are very happy with his bedside manner and skill as a surgeon. I think most adjusters of workers’ compensation claims also respect his knowledge, integrity, and fairness. Dr. Peoples’ office is at 2865 Siena Heights Dr., Ste. 131, Henderson,NV 89052. His phone is 702 616-6580.
