Doctors Operate on People
Diagnosed With Chronic Fatigue
By THOMAS M. BURTON
Staff Reporter of THE
(Article review by Dr. Robert
This was the headline
in the Wall Street Journal on November 11th. 1999.
It referred to an
article about a controversial surgery that some doctors are performing
on patients with chronic fatigue and fibromyalgia.
A new belief among a few neurosurgeons is that these patients'
troubles can stem from a squeezing of the brain or spinal cord by a
too-tight skull or spinal canal. For about $30,000 a case, they are
drilling and snipping away bone from the backs of people's skulls and
spines to "decompress" their brains, spinal cords and central
Some of the proponents were very
enthusiastic. "This is
like telling the story of the discovery of insulin," said Chicago
surgeon, Dan S. Heffez. You're talking about a completely new insight
about a condition that has baffled people since the beginning of the
Other surgeons were very critical.
"Is this on a par with insulin? Not on your life," says
Peter Carmel, neurosurgery chairman at New Jersey Medical School in
Newark and an authority on the skull malformations at issue. "Would
I offer a patient an operation the way they do? No."
The article goes on to note that this
surgery may succeed because this group of patients may be particularly
susceptible to a placebo effect. Dr.
Clauw a rheumatologist at Georgetown University in Washington was quoted
as saying, My feeling is that Rosner and Heffez are moving way too
rapidly." But he agreed that a small proportion of fibromyalgia and
chronic-fatigue patients probably have brain or spine compressions.
The proponents of this form of surgery
believe that the problem facing some patients with symptoms of
fibromyalgia and chronic fatigue is a congenital skull malformation
called Chiari I malformation. The
other condition that they believe causes similar problems is cervical
spinal stenosis (a too-narrow spinal canal at the level of the neck).
This surgery is currently being performed
1. Dr. Michael Rosner at Park Ridge
Hospital in Fletcher, N.C
2. Dr. Daniel Heffez at the Neurosurgical Institute in Chicago.
3. Dr. John D. Weingart at Johns Hopkins University Medical Center.
Dr Rosner has performed about 250 of
these operations. Drs. Heffez and Weingart have performed about 75 such
article ended on a positive note. Ms.
Plaza who was operated on by Dr. Heffez, was ecstatic . Before the
four-hour operation, she says, she had headaches, blurred vision and
fatigue "so powerful I had to lean against the wall." Now, she
says, many of these symptoms have abated so much that "I feel like
I could conquer the world."