Dr. Bex
speaker
498 appearances
7 recordings
1 series
first heard Nov 2024
last heard Jun 2025
Dr. Bex’s voice in public audio — every appearance, attributed to the second.
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But there are all these different angles that they mention and lines and distances. And I think the ones that are the most studied are what I talked about before, that measurements If your spinal cord hangs lower than L2, most physicians, most neurosurgeons would say it deserves looking into to see if there is a tethering that's causing it to pull down. And then the herniation.
If the Chiari drops below 5 millimeters and you put a room full of neurosurgeons, most are going to agree that that is a Chiari malformation. Then you get into all these different ones. angle measurements for how much that area is being compressed and all of that. It sounds very mathematical.
And so there is reason to believe that people are like, great, if this gives us a measurement, that makes our lives easier because if they meet that measurement, then most would agree. The thing is, it's not there yet. those measurements are not to the point, those more, the measurements that are not reviewed as much in the studies is going to be very operator dependent, very doctor dependent.
And if you look them up, the studies that have documented them are by Thomas Millerat, Paolo Bolognese, and this Masao Nishikawa. And so if they're the ones doing the studies and they're the ones doing the measurements, And if it's a certain measurement, it means they qualify for a surgery. And then that means they do the surgery.
I'm just saying it needs to be there needs to be I keep saying this word grounding, but there needs to be an objective outlier, a person who is not benefiting from all this that is doing the measurements. Because if that person is also benefiting, I mean, I'm just going to say you're human and there's going to be some, you know, inherent bias versus it being measured by an outside entity.
In light of dozens of lawsuits.
Most of the ones they use, right.
So it's named that because of the Chiari Institute, but the idea is you correct everything in one fell swoop. So the idea is you do a Chiari decompression, which is where you remove the bone that is basically causing the pressure on the brainstem. So just because the brainstem is a little bit lower, the problem is it's trying to fit through a tiny little hole and that's where the pressure comes in.
So you relieve it. That is the procedure of choice. When someone truly has a Chiari and truly is symptomatic, you do a decompression. But the idea is they do that in association with what is called a cranial cervical fusion. You attach the skull to the spinal cord. So you fuse it together using either rods or, you know, there's all different ways to do it. But they basically join it. They fuse it.
So it's not so... It doesn't have as much mobility, which indirectly could cause symptoms. And then you do what's called an odontoid resection, which is part of your second cervical vertebrae. It sounds like they either realign it or they actually resect part of that vertebrae because the idea is it is also causing compression.
The thing is, I looked it up, the risk of any Chiari decompression is like 1% to 5%. but up to 10% can have something called a CSF leak where afterward your spinal fluid can kind of be leaking because you're opening up a space that has fluid inside of it. So like 10% could have a leak.
The fusion has a one to 4% chance of risk or of some bad outcome, but it's much higher, the higher in the spine you go, which makes sense. So the cervical spine, if you damage, I mean, anyone who knows if you injure or break something in your neck, you're from there down. If you do something in your lumbar spine, it's from there down.
So the idea is the higher the fusion, the higher the risk because it controls so much more. And then the odontoid resection is a piece that is not very well reviewed or well studied so that we don't even know the risk factors.
But so the people who are kind of naysayers of this or the neurosurgeons who kind of say something about this doesn't feel right is because you're taking multiple risky procedures, putting them into one procedure, under one anesthesia session, and then that there's really no consensus on why you got there in the first place, let alone consensus to do all of these things.
And then that there were probably, most neurosurgeons would say there were other alternatives to some of these things, meaning have those other pathways been followed? Have they tried bracing for the instability instead of going straight to a fusion? And because the diagnosis comes into question, I think it just makes each of these individual pieces more concerning.
And then when you do them all together, even more concerning.
They want to take her to this New York neurosurgeon who has multiple malpractice claims against him. That was actually – it was actually brought up during the case. That's interesting.
Right, the complaint of Madison Meyer. So this is what we had focused on prior to this was the complaints and the court process that was kind of going on between the parents, William Meyer and Dana Gaske, against the defendants, including Rady Children's Hospital and then the County of San Diego and all of the other defendants that kind of came along with that.
Now we started jumping into the story of Madison Meyer, who rejoined, kind of came back in, or we started to hear about again in 2023. And then now we're at the third amended complaint by Madison Meyer since the two, Court cases have been merged, so now it's the parents and Madison are all involved in one kind of court proceeding.
And this is the third amended complaint that actually just came out this year in 2025 and just very recently within the last couple weeks. And so I just looked last night, and there has been a response by the defendants to basically – you know, dismiss the whole claim, the whole thing, but the judge has not responded. The court has not responded. So that's where it stands as of recording today.
Showing 81–100 of 498 · page 5 of 25
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