Carl Kao's Surgical Procedures in Ecuador
Dr. Carl Kao is a neurosurgeon who is offering a combination therapy. He is willing to travel to various places in the United States and see people. He operates in a clinic in Ecuador. From the description of various people who have visited him, he offers the following therapies that are often combined:
• decompressive/untethering surgery
• implantation of a sural nerve (which presumably provides Schwann cells that serve as a bridging environment for axonal growth and also cells that remyelinate the axons)
• omentum transposition (which apparently differs from the pedicled omentum that Dr. Harry Goldsmith uses in that he uses local blood vessels to provide the flow) to revascularize the injury area
• exercise program (exercises for different parts of the body, as well as boots and other devices that he recommends for specific situations)
• 4-aminopyridine to increase the excitability of the spinal cord in the post-operative period.
See Birde's topic on Carl Kao's procedures in the Cure Forum
[This message was edited by Wise Young on August 06, 2001 at 01:40 PM.]
URL links for various sites and information on Carl Kao
More links from Birde
hospital in Ecuador that Kao works out of...Clinica Primavera
http://www.clinicalaprimavera.com/ (click on Bienvenido) Everything is in Spanish and the English version doesn't seem to work, however if you bookmark the site and go to: [URL=http://babel.altavista.com[/URL] and put in what you want translated (spanish to english) it will work.
Note (from Wise): For some reason, the www.clinicalaprimavera.com site does not work for my browser but other people might be able to gain access to it.
you can try this link as well to see the clinic in Ecuador
Thanks, Birde, the new link works for me.
Dr. Kao contact information
PHONE: 202-362-6421 FAX: 301-388-0994 ADDRESS: 3801 Connecticut Ave., N.W.,Suite 100 Washington D.C. 20008
hi there dr.young,what do you think about this surgery?in your terms,not docter terms,will his surgery affect us in any way from something else that comes along?how or is he getting those axons to grow out of the injury site?just getting bowel,blatter and sexual fuctions would be worth the money,and if things are so positive with his surgerys how come he isnt teaching other docters his process?you would think this would go through the fda in a blink of a eye,but hes not even trying,why?thanks a ton for your help,jeff pike
I hesitate to express my personal opinion on clinical trials because I really would prefer that people judge the therapies for themselves and that I provide facts rather than judgments concerning the trials. But I do want people to start discussing the trials. So, here goes.
In my opinion, Karl Cao is a very good neurosurgeon. I have known him for over 20 years and continue to be impressed by his skill, compassion, and honesty. He is a gifted and very experienced surgeon. I like the fact that he charges minimally for his work and the reasonable way in which he is presenting the results of his work. I have seen videos of his surgery and have known perhaps a dozen people he has operated on. I have not heard of any disasters and think that he is circumspect in his claims. Many of the cases that he has operated on are very complex and the patients have done well.
My understanding of his surgical procedure is as follows. He does a laminectomy to expose the spinal cord and does meticulous removal of any scar tissue and tethering that he sees. If the patient has a syringomyelic cyst in the spinal cord, he opens the cyst through the midline, implants the sural nerve (a sensory nerve in the leg) into the cyst. He then places an omentum transplant onto spinal cord which, I believe, prevents adhesion between the spinal cord and dura (a common complication of spinal surgery). He uses muscle fascia (the membrane covering muscles) to extend the dura so that it can accomodate the extra-bulk of the omentum (other neurosurgeons use artificial or cadaveric dura). He has special exercises that he has people do. In addition, he gives them 4-AP during the rehabilitation.
This appears to be a reasonable procedure and one that will benefit people who have compression and/or tethering of the spinal cord. If a person does not have compression, tethering, or a cyst in the spinal cord, I don't think that surgery would be warranted. There is little data from either animal or human experience suggesting that a peripheral nerve transplant would improve function. On the other hand, there is quite a bit of data indicating the decompression, untethering, and removal of adhesions may restore function even many years after injury, as well as collapse syringomyelic cysts. I find his use of the omentum graft to be innovative and think that it very likely helps. There is no convincing evidence that omentum transplants restore function but I think that the concept that it reduces scarring is very attractive. I also think that his use of muscle fascia to expand the dura is a very good idea.
Many other surgeons do decompression and detethering surgery. I know some people who have been through such procedures in the United States and Europe. In general, I have found patient satisfaction with these procedures in the U.S. to be lower than with Carl Kao. This was quite surprising to me. I think that the Tijuana Clinic that does shark embryo transplants may be using some of the techniques that Carl Kao uses but I think that patient satisfaction with Carl Kao is higher. Several overseas centers do omentum transplants but I have met some people who have been dissatisfied with the followup care.
I do want to emphasize the anecdotal nature of the above information. I would feel more comfortable with the situation if he were operating in the U.S. and published his experience. There is a history of antagonism between Carl Kao and the neurosurgical community. This may be one of the reasons why he operates in Ecuador. At the same time, it is clear that the costs of surgery and care is much lower in Ecuador.
I hope that his helps.
dr.young,thanks so much for your help,i come on line to listen to you and others about what is going on,other then that i hate this computer more then anything,i cant sit still but have to in a way.I sent my x-rays and mri's to dr.kao this weekend to look at,you brought up about having tethering,compression or cyst,should i ask my docter here in san deigo that did my surgery about these things?i just know he is really negative about anything that could help me,he sits there and tells my mom and me that there will be help for me when there is to many poeple on mars and all of the different colleges he talks at and how much he knows,its just really a nightmare to me even talking to him.I hope you understand iam trying to learn day by day about this(oct 99 complete-7)thank-you jeff pike
pictures of the procedure that Dr. Kao does and of the inside of the Ecuador hospital
http://runningbear.com/main/Ed/text/...Surgery-1.html ****pictures of Ed's operation at the end of the page click on the next button and the 2cnd set of pictures will pop up. http://runningbear.com/main/Ed/text/...-Inside-1.html ***pictures of the inside of the clinic