Aebi, Max

Gunzburg, Robert

Szpalski, Marek

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The paper of M. Putzier et al. ‘‘Charite´ total discreplacement—clinical and radiographical results afteran average follow-up of 17 years’’: Eur Spine J 2006Feb;15(2):183–195, Epub 2005 Oct 28, created a lot ofreaction and controversy, partially documented in theletters to the Editor and the answers published in EurSpine J 2006, April;15(4):510–522. Specifically theauthors of the original Charite´ disc used the opportu-nity to comment on the development and their ownperception of the outcome of the first commercialavailable lumbar disc replacement. The letters to theEditor became quite voluminous, and it cannot be thefunction of a peer-reviewed journal to allow underthe label of a letter to the Editor basically a scientificresume, which would normally not pass in a peer-reviewprocess. In this specific context—exceptionally—weallowed that, because the significance of the newtechnology of disc replacement is a major issue oftoday’s spinal care and spine surgery. Since theseimplants are gradually invading the spinal market forregular clinical use, a lot of controversy and debatesabout the sense and nonsense of this new technologyhas been provoked.It is today difficult to say, whether we are with a discarthroplasty at the beginning of a glorious time of newspine care similar to what the total hip and kneereplacement meant in hip and knee arthritis. Manyelements of the today’s knowledge speak against that,however, there are elements and mainly hopes thatthere is coming up a better tool to deal with low backpain and neck pain in the context of degenerative discdisease. This dream is not new, since developments canbe tracked back in the second-half of the last century.Whether we see presently a fundamental paradigmshift in the treatment of degenerative spinal diseases isquestionable, and nobody can really answer that with aclear yes or no. Therefore, a journal like the EuropeanSpine Journal has the duty to allow this dispute anddiscussion in the open broader public of the spinalcommunity, not only to be better informed, but also tostimulate thoughts and new innovations, which mayfinally benefit our patients.The so-called evidence-based medicine and thefailure of many different therapies in the treatment oflow back pain have reduced in many surgeons theoptimism and the hope that we can treat this patientcollective with surgical tools. Therefore, a certaintechnology resistance is developing not only becauseit is difficult to imagine that new technology willaddress this complex issue, but also because increas-ing costs in health care will make it very difficult fornew technology to stand the tests of time and ofevidence. However, there is no medicine without thehope into improving our treatment modalities andtools to alleviate the suffering of our patients. Thecuriosity and the constant drive to do better for ourM. Aebi (&)Institute for Evaluative Research in Orthopaedic Surgery,University of Bern, Stauffacherstrasse 78, 3014 Bern,Switzerlande-mail: max.aebi@MEMcenter.unibe.chR. GunzburgEeuwfeestkliniek, Harmoniestraat 68, 2018 Antwerp,BelgiumM. SzpalskiIRIS South Teaching Hospitals, Rue Marconi 142,1190 Brussels, BelgiumEur Spine J (2006) 15:1033–1034DOI 10.1007/s00586-006-0153-5123EDITORIALControversies in new technologies: how should a scientificjournal stand?Max Aebi Æ Robert Gunzburg Æ Marek SzpalskiPublished online: 6 July 2006 Springer-Verlag 2006patients are major ingredients to make this worldbetter for patients, who are desperate for medicalhelp.Therefore, a modern society with a lot of potentialfor new technology and better approaches for thetreatment of our patients has to remain open for newapproaches and methodologies to support progress.We cannot tolerate a paralyzing pessimism towardseverything, which is new. Somebody will pick it up andif we as an academic journal of a learned society do notexpose ourselves to this challenge, we may suddenly beoff the window.1034 Eur Spine J (2006) 15:1033–1034123

Controversies in new technologies: how should a scientific journal stand?

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Controversies in new technologies: how should a scientific journal stand?

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