To Your Health
June, 2011 (Vol. 05, Issue 06)
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Back Surgery: Too Many, Too Costly and Too Ineffective

By J.C. Smith, MA, DC

There's an 80 percent chance you'll suffer back pain during your lifetime, for which your medical doctor will likely recommend over-the-counter pain medication or prescription medication to relieve the pain temporarily.

Depending on your doctor's assessment and how you respond, they may even consider you a candidate for spine surgery at some point, an increasingly likely (and dangerous) option.

Then there's chiropractic, which research and experience show is the safest, most effective option for most cases of back pain. Unfortunately, too many people end up in a medical doctor's office instead of a chiropractor's office, which accounts for the rampant use of medications and surgery for back pain, particularly here in the U.S. Here's why back surgery – and medical management of back pain in general – is too frequent, too costly and too ineffective, and why chiropractic care should be your first option when dealing with back pain.

Too Many, Too Costly

Research suggests that of the 500,000-plus disk surgeries that are performed annually (a significant increase of late), as many as 90 percent are unnecessary and ineffective. Richard Deyo, MD, a professor at Oregon Health and Science University, notes, "It seems implausible that the number of patients with the most complex spinal pathology [has] increased 15-fold in just six years" and mentions one strong motivation includes "financial incentives involving both surgeons and hospitals."

broken back - Copyright – Stock Photo / Register Mark A study conducted by Deyo and Cherkin in 1994 compared international rates of back surgeries and discovered that the rate of American surgery is unusually excessive and directly attributed to the supply of spine surgeons: "The rate of back surgery in the United States was at least 40 percent higher than any other country and was more than five times those in England and Scotland. Back surgery rates increased almost linearly with the per-capita supply of orthopedic and neurosurgeons."

On the Top 10 list of diseases in America, "back pain" stands at number eight, which according to Forbes.com costs over $40 billion annually for treatment costs alone. Other estimates that include disability, work loss and total indirect costs range between $100 and $200 billion per year. Back pain sent over 3 million people to emergency rooms in 2008 at a cost of $9.5 billion, making it the ninth most expensive condition treated in U.S. hospitals.

What accounts for these staggering costs? We know one thing: Doctors and hospitals are making huge profits off the backs (no pun intended) of unsuspecting patients who are not told there may be better and cheaper ways to solve their back pain with chiropractic care or other non-invasive methods. Back surgeries are among the most expensive, and these costs do not include hospitalization, imaging, drugs or medications. Just take a look at these per-surgery costs for various types of back surgeries:

  • Anterior cervical fusion: $44,000
  • Cervical fusion: $19,850
  • Decompression surgery: $24,000
  • Lumbar laminectomy: $18,000
  • Lumbar spinal fusion: $34,500

Dr. Deyo found the mean hospital costs alone for surgical decompression and complex fusions ranged from $23,724 for the former to $80,888 for the latter. When combined with surgical costs, medications, magnetic resonance imaging (MRI), rehabilitation and disability, the average spine surgery case approaches $100,000 or more. The direct costs are astronomical and may reach as high as $169,000 for a lumbar fusion and $112,000 for a cervical fusion.

Fortune 500 companies spend over $500 million a year on avoidable back surgeries for their workers and lose as much as $1.5 billion in indirect costs associated with these procedures in the form of missed work and lost productivity, according to a two-year study by Consumer's Medical Resource (CMR). The study, "Back Surgery: A Costly Fortune 500 Burden," found that one out of three workers recommended for back surgery said they avoided an unnecessary procedure after being given independent, high-quality medical research on their diagnosed condition and treatment options. In addition, patients who refused surgery and opted for alternative and less invasive procedures to treat their back pain reported experiencing healthier and more personally satisfying outcomes.