- We strive to provide complete care for our patients. Learn more about all the services we provide.
You are using an outdated browser. Please upgrade your browser to improve your experience.
Pushing Back on Back Surgery
Special to the Red Bluff Daily News
In a furious game of touch football,
Within a month, the "40 something" marketing manager at the
As those numbers have multiplied, so have questions about the more aggressive forms of back treatment. A 2008 study in the Journal of American Medical Association, for example, noted that the increase in back-care spending occurred "without evidence of corresponding improvement" in patient's health.
"Intense pain is not necessarily an indication for surgery," said Dr. Richard Deyo, a professor of family medicine at Oregon Health and
Perhaps the biggest controversy involves an invasive surgery called spine fusion, which attempts to relieve back pain by permanently connecting (or fusing) several levels of bone in the spine.
While the overall number of back operations has flattened out in recent years, complex fusion surgeries, which can cost upward of $80,000, continue to proliferate. American surgeons now perform twice as many of these operations as their counterparts in most European countries,
This debate is likely to intensify under the sweeping new federal health legislation that President Obama signed in March, which will gradually require doctors and hospitals to demonstrate that their services are cost-effective. In that vein, the New England HealthCare Institute estimates the
Fusion surgery has historically been used to correct deformities, fractures, complications related to tumors and other rare conditions. The surgical results have been good, and largely noncontroversial.
But in recent years, more and more of these procedures have been used to treat back pain related to aging, prompting several studies to question whether the expensive intervention is worth it.
Fusion involves a surgical tool kit consisting of screws, rods, cages, and plates. Also sometimes a biologic product made by Medtronic called Infuse, which grows bone between the vertebrae in an effort to stabilize the spine.
In 2006, American doctors performed approximately 343,000 spine fusion operations; up 82 percent from 1999, according to the
The cost of fusion surgery varies widely, according to data compiled by United Health Group; the
Deyo has argued that the rising costs, high rates of complications, second surgeries, and wide variations in the number of procedures performed from one state to another "generate concern that the procedure may be over used."
Others claim the increase in fusion surgery may be related to improvements in technology and the simple fact that baby boomers are aging. "Americans think longevity is a right and death is optional," said Dr. Sam Ho; chief medical officer for UnitedHealth Group, the nation's largest insurer. "We all want to be as active as we can - and for as long as possible."
The surge in fusion surgery has meant big money for
Critics argue that influence by big medical device companies - including lucrative royalty and consulting arrangements bestowed on top surgeons whose opinions hold sway among their colleagues - is one reason why the number of spine fusion surgeries has skyrocketed. Earlier this year Medtronic disclosed these payments to doctors for the first quarter. Of the $16 million Medtronic paid in those three months, $14 million went to spine and orthopedic specialists mostly for royalties.
Medtronic and others insist that collaboration with doctors is crucial for creating and perfecting innovative new tools to treat patients. But Dr. Charles Rosen, a
Other specialists say the situation is more nuanced. Each patient is different, they say.
"Is there too much back surgery? Yes, "said Dr. John Sherman, an orthopedic surgeon with Twin Cities Orthopedics, one of the nation's biggest practices of its kind. "But it's not as dark as (Dr.) Deyo portrays it, nor is surgery a panacea for curing all back pain."
One satisfied patient is Amy Leyden, who turned down surgery "out of pure fear" and went to 24 rehab sessions at Physicians Neck and Back Pain instead.
"You're pushed," she said. "It's like having a personal trainer. But I would have never done it on my own. As soon as it got painful, I would have quit."
It worked. Today,
Sign-up using the form or call us at 530-342-6441 to learn more about us.
|Monday||8:30am - 12pm||2pm-6:00pm|
|Tuesday||8:30am - 12pm||2pm - 5:00pm|
|Wednesday||8:30am - 12pm||2pm - 6:00pm|
|Thursday||8:30am - 12pm||2pm - 6:00pm|
|Friday||8:30am - 12pm||2pm - 5:00pm|
|8:30am - 12pm||8:30am - 12pm||8:30am - 12pm||8:30am - 12pm||8:30am - 12pm||Closed||Closed|
|2pm-6:00pm||2pm - 5:00pm||2pm - 6:00pm||2pm - 6:00pm||2pm - 5:00pm||Closed||Closed|
3D Spine Simulator