User:Snake playing a saxaphone
Almost all medical editing is based on standard treatment guidelines. Unfortunately, the standard treatment guidelines can be 30 years behind current medical research. This is due to the time it takes to amass the necessary studies on things like safety, efficacy, and cost-effectiveness for a new treatment to be accepted by the many institutions involved in public health.
Innovations in medicine can radically change the understanding, diagnosis, and treatment of disease. Germ theory, anesthesia, hand washing, MRI, etc are prominent examples, but the scope of an innovation may just touch on a single disease (discovery that peptic ulcer disease was primarily caused by a specific bacteria), or a category of diseases (discovery of spinal disk herniation as a major cause of sciatica). Regardless of scope, medicine before was nothing like medicine after. New innovations will change today's medicine similarly. When they happen, you might not want to wait 30 years to hear about it.
There are three core medical innovations I write about, all related to the field of nerve entrapment:
- Image-guided injection. With the use of CT/MRI, it is now possible to perform an "inverted palpation" almost anywhere inside the body. Palpation in simple terms means poking at something. While a palpation will send a signal along a nerve, the injection of anesthetic will block the signal sent along a nerve. The use of high-resolution imaging like CT/MRI allows us to know exactly the needle position to the cubic mm. It is now possible to get the same information internally with an image-guided injection, as we get with palpation externally.
- MRN/DTI. Conventional MRI cannot adequately visualize peripheral nerves due to their tissue properties. Specialized pulse sequences and protocols were necessary to have any chance at visualizing nerve tissue. MRN (magnetic resonance neurography) and DTI (diffusion tensor imaging) are the most promising technologies for nerve visualization, and they have finally become practical with the commercial development of 3T MRI machines. These technologies can visualize structural and functional properties of nerves where conventional MRI hasn't been able to. As a corollary, they can assess the location, extent, and spatial distribution of nerve lesions. Especially with newer 7T machines and standardized protocols, it will be possible to diagnose nerve pathologies using an MRI scan with the same accuracy and reliability we do for broken bones using a CT scan.
- Endoscopic nerve decompression. The advent of endoscopic surgery radically changed the treatment options for peripheral nerve entrapment. Where open surgery proved to be too unpractical to access many parts of the body, especially the pelvis, endoscopic surgery allowed surgical access to almost anywhere inside the body. Suddenly every peripheral nerve in the body became surgically accessible. That surgical access allows us to perform nerve decompressions anywhere. Nerve decompressions treat the underlying cause of entrapment syndromes, and typically start with a 30%+ cure rate and an 80% success rate (50% or more decrease in numerical pain scores). The previous treatment options were all symptomatic, untargeted, and had no hope of a cure.
Each of these innovations is transformational compared to the old ways of doing things. Each 0 to 1 innovations. Chained together they can form a complete solution to previously untreatable disease: A single MR scan can localize a suspected compressive nerve lesion within a cubic centimeter; A single image-guided injection can confirm this unambiguously; An endoscopic nerve decompression can permanently, curatively treat it. No more lifetime subscriptions to chronic pain centers and all the limitations of chronic pain.