Older Adults Increasingly Face Complex, Risky, and Costly Spinal Stenosis Surgery
Posted by Doctor under Articles, Chronic Back Pain, Newsletter on Wednesday, April 7th, 2010 1:31 pmPatients may ask about a study showing that older adults with spinal stenosis are more frequently undergoing complex (and more hazardous and expensive) surgery.
Writing in JAMA, researchers detail an investigation using Medicare claims data between 2002 and 2007. During that period, the overall number of lumbar stenosis operations declined slightly, while use of the most complex approach increased some 15-fold.
In examining 2007 data, the researchers found that more complex fusion operations had double the rate of major medical complications and double the 30-day mortality of decompression alone. The average hospital charge for the more complex procedure was some $80,000 — versus $24,000 for decompression.
An editorialist concludes that “conflicting economic incentives are clearly at work,” noting that a surgeon’s reimbursement for the more complex approach can be ten times that of simple decompression. Current financial incentives and market forces in medicine, he says, amount to “a formidable economic and social problem.”
