John F. Kennedy’s Unsuccessful Back Surgeries and Chronic Back Pain

T. Glenn Pait, MD, and Justin T. Dowdy, MD, reveal more about JFK's chronic back pain and possibly his death in this historical vignette.

John F. Kennedy was the symbol of youth and vigor when elected into office in 1960. However, researchers recently uncovered medical information showing Kennedy’s life-long medical problems, including unrelenting chronic back pain that became pronounced his 20s and lasted until his death, explained Justin T. Dowdy, MD, in a recent review article in the Journal of Neurosurgery Spine.

President John F. Kennedy speakingJohn F. Kennedy was the symbol of youth and vigor when elected into office in 1960. However, researchers recently uncovered medical information showing Kennedy’s life-long medical problems.The Mystery Surrounding John F. Kennedy’s Health
“When the Kennedy Presidential Library allowed biographer and noted presidential historian Robert Dallek access to previously restricted materials approximately 15 years ago, it opened a new window into the study of his health,” explained Dr. Dowdy, who is a neurosurgeon at Hot Springs Neurosurgery Clinic, in Hot Springs, Arkansas. “In his definitive biography of Kennedy, Dallek reported that the President’s x-rays demonstrated a compression fracture in his lumbar spine, which as it turns out is false.”

“Uncovering that information proved to be the tip of the iceberg as the research ultimately revealed much more about President Kennedy's chronic back pain and the prominent role it played in his life and possibly even his death,” Dr. Dowdy said. “Until recently, most of the issues surrounding his health remained a mystery.”

John F. Kennedy’s back pain is thought to have started following a football injury, while Kennedy was in undergraduate school at Harvard, explained Dr. Dowdy. Kennedy’s back problems worsened when he was in the U.S. Naval Reserve and his ship was hit by a Japanese destroyer. Kennedy swam for 5 hours to a nearby island while towing a wounded crewman to shore by holding the strap of the man’s life jacket between his teeth, the researchers noted in their paper.

Four Back Surgeries Were Largely Unsuccessful
Various physicians treated Kennedy, including experts at the Mayo Clinic and Lahey Clinic, and had different theories on the cause of his back pain, explained senior author, T. Glenn Pait, MD, Director of the Jackson T. Stephens Spine and Neurosciences Institute at the University of Arkansas for Medical Sciences.

Dr. Pait believes that, ultimately, Kennedy had discogenic disease stemming from an injury in his youth that started a cascade of problems. The Mayo Clinic and Lahey Clinic recommended against surgery.

However, “much like what we see today, Kennedy told his physicians that he could not live with the pain,” Dr. Pait explained. “With further insistence from his father, Joseph P. Kennedy Sr, the neurosurgeon at the Lahey Clinic decided to go forward with surgery, which consisted of a left L4–L5 laminotomy and L5–S1 discectomy. The surgery was a failure, which prompted further evaluation.”

The review article describes that Kennedy went through 3 more back surgeries, including sacroiliac and lumbosacral fusion (that led to a serious wound infection), subsequent implant removal, and surgery to repair a superficial lumbar abscess.

In addition to surgery, he received a variety of treatments ranging from trigger point injections and a physical therapy program (swimming and weight lifting), to massage and a back brace, narcotics, and methamphetamine-containing shots administered by Max Jacobson, MD, also known as Dr. Feelgood.

The physical therapy (weight lifting three times per week and swimming almost daily) resulting in dramatic improvement. His physician sought to wean Kennedy from his long-time reliance on a corset-type brace.

Kennedy’s reliance on his back brace may have contributed to his death, as he wore his brace and also wrapped his trunk in an Ace bandage, Dr. Pait told SpineUniverse. When the first shot was fired in Dallas, Kennedy’s tightly bound lumbar brace appears to have caused him to return to an upright position, rather than crumpling forward as would be expected, and allowing Kennedy to return to the line of fire for the second fatal shot to the head.

Reconciling Symptoms to Imaging Abnormalities
“The case study of JFK’s back highlights issues that continue to bedevil practitioners who evaluate and treat spinal disorders; namely, how to reconcile patient symptoms with imaging abnormalities and develop an effective treatment plan with this information,” Dr. Dowdy said.

“How might his treatment/surgery be altered if he were a patient presenting in a spine surgeon’s office today?,” Dr. Dowdy speculated. “The biggest difference over the last 70 to 80 years is the technologic advancements surrounding diagnostic imaging and surgical treatment that simply weren’t available to the world-class physicians in charge of treating JFK’s spine disorders. There is no doubt that if JFK were being treated in the modern era, we would have a much more detailed picture of the structural abnormalities of his spine, which may have led to a different trajectory of care for the President.”

The difficulties in correlating the symptoms of patients with chronic back pain to their imaging abnormalities and developing effective treatment plans remains challenging to this day,” Dr. Dowdy concluded. “A comprehensive approach emphasizing healthy back hygiene is necessary on the front end, and access to a trusted spine surgeon who is able to effectively diagnose and parse out the situations where surgical intervention is likely to be beneficial is an indispensable part of this process.”

Additional Reading
Forest Tennant, MD, DrPh, published his findings and perspectives about President Kennedy in, John F. Kennedy's Pain Story: From Autoimmune Disease To Centralized Pain, on PracticalPainManagement.com, a Vertical Health, LLC website. To access Dr. Tennant’s article, click here.

Updated on: 02/08/18
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