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Spinal Fusion Surgery Worth the Cost for Stenosis Patients?

Back pain will affect over 80% of people in the U.S. at a cost of >$100 billion a yr. While many conditions can be treated conservatively (non-surgically), sometimes surgery is necessary. The question becomes whether or not the high cost of spine surgery is worth it.

A study conducted at Rush University Med Center suggests that for patients w/ spinal stenosis, laminectomy or surgical removal of pain-causing soft bone & tissue, is a reasonable value. However, for patients w/ spinal stenosis & associated slipped vertebrae, the benefits of spinal fusion surgery may not be worth the costs.

Rush was 1 of 13 sites that followed patients in this Spine Patient Outcomes Research Trial (SPORT). This significant study was the first to track healthcare cost, along w/ health outcomes. With >650k annual U.S. spinal surgical procedures at costs over $20 billion, value is an important consideration

The study consisted of 3,900 patients w/ 1 of 2 conditions: spinal stenosis treated w/ laminectomy & spinal stenosis w/ slipped vertebrae, treated w/ spine fusion surgery. The patients were divided into groups of non-surgical vs. surgical treatments; of the surgical patients, 320 underwent laminectomy & 344 had spinal fusion.

Researchers used the Quality Adjusted Life Year (QALY) scale to perform a cost/benefit analysis over a two-year post-surgery period. Laminectomy was calculated to cost $77k per QALY gained, while spinal fusion surgery was estimated to be $115k per QALY gained. In the United States, $100k is the max at which procedures are considered cost effective.

While the initial analysis indicates that laminectomy offers better value than spine fusion surgery, a definitive assessment of long-term cost effectiveness is still in the works. However, the bottom line is that for many patients suffering from back pain, relief is worth any cost.

The study is published in the Annals of Internal Medicine.

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