Forensic Spine Analysis

Forensic Spine Analysis provides pure auditing for both pre and post operative spine surgery validity in large hospital systems.

Dr. John C. Nordt, a spine surgeon in private practice in South Florida, has long term and significant experience in determining the justification of spine surgeries for insurance determinations, for legal defense and liability for accidents on the defense side. The results of his work are successful defense verdicts in court, and the minimization of losses related to unwarranted surgeries or surgeries that had already been executed. As a private practitioner, Dr. Nordt reviews countless unsubstantiated, non-validated spine surgeries. One of the main mistakes is basing recommendations for surgery on image only (i.e., MRI) findings without any clinical substantiation. In many cases, when the images are removed from the diagnostic equation, ultimately there is no valid diagnosis because there is no clinical relevance documented by the physicians. Dr. Nordt practiced for 10 years before MRIs were invented and clinical relevance had a very high importance.

Forensic Spine Analysis is based on the belief that, especially in South Florida, up to 50% of surgeries do not have valid criteria for spine fusion. The financial ramifications to insurance companies are obvious. Forensic Spine Analysis is well positioned to be an asset in investigating the validity of these surgeries both pre and post operatively.

While the bulk of the analysis is conducted in the pre-op situation, Forensic Spine Analysis offers services in the the post op scenario as well. Medicare, since 2008, has demonstrated with RACs (Recovery Audit Committees) that their evaluation criteria leads to significant financial recovery.

This involves total joints specifically. Spine is much more sophisticated and complicated to understand. The sophistication of tests, imaging techniques, physical therapy and computer generated histories leave a lot to be desired in documenting the appropriateness of clinical criteria to perform spine fusions.

The Medicare Recovery Audit Committees, which have been in place for some time, offer post operative financial relief on the Medicare side. However, private insurance companies are also at risk for tremendous losses, especially in large hospital systems that employ spine surgeons that are routinely pressured to justify their productivity/salary/quotas through high RVUs.

Journal of Bone and Joint Surgery (JBJS) March of 1990 – Basically 50%of MRIs in 100 normal people showed a significant operable lesion but all of them had never had a back problem in their life.  Therefore, the MRI does not justify the surgery.

On the other side, the profession of pain management in the last 20 years has grown exponentially and been used as a cover up for failed spine surgeries. The underlying proposition in all of Dr. Nordt’s analysis is an outcome study for spine surgeries based on one question to the patient:  are you still taking narcotics at the end of 6 months? This would underscore that surgery as being a failure.

Forensic Spine Analysis was founded on Dr. Nordt’s experience over the past ten years in successfully analyzing spine surgeries from both an insurance perspective and a legal standpoint.

As the incoming president of the Florida Orthopedic Society, he takes on a tremendous responsibility to promote and maintain a high level of integrity as it pertains to quality medical musculoskeletal care to patients as well as a fiscal responsibility from a business perspective.

Forensic Spine Analysis readily demonstrate that its services impact the bottom line.