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.”

High Blood Sugar Better in 1 Week! Plus She Lost 11 Pounds!

79 year old man gets relief from chronic pain in 3 treatments! Listen to this!

© Georg Thieme Verlag KG Stuttgart · New York

Lumbar radiculopathy
Epidural injection of steroid and pain medication versus placebo

Summary

Epidural steroid injections for treatment of sciatica did not confer
significant additional benefit over placebo injection in patients who
had had symptoms for less than one year. While steroid injections may
afford short-term improvements in pain and movement, this beneficial
effect was transient, and there was no statistical difference between
active and placebo treatments after 4 weeks of follow-up. Treatment of
sciatica with epidural steroids has exhibited no significant
functional benefit, nor does it reduce the need for surgery. Outcomes
varied minimally by injection site across studies, not based on direct
comparisons.