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Spinal Fusion Surgeries Up in Elderly, Putting Patients at Risk

Apr 12, 2010 | Parker Waichman LLP
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Risky spinal fusion surgeries are increasingly being performed on elderly patient, according to a new study. The surgeries, which often use devices made by Medtronic Inc. and Zimmer Holdings Inc., often lead to life-threatening complications in these patients.

The study focused on women and men age 65 and older diagnosed with lumbar stenosis, a common back problem in which aging spinal vertebra pinch the spinal nerves. According to the study, which appears in the Journal of the American Medical Association, spinal fusion, accounted for 14.6 percent of all back surgeries for Medicare patients in 2007, up from less than 1 percent in 2002. The study is the first to look at the rate of spinal surgery and its complications and cost in a large group of Medicare patients.

The study also found that spinal fusion patients showed a doubled rate of life- threatening complications, 5.6 percent, compared with a simpler back surgery called decompression. The more complicated surgery generated average hospital charges of $80,888 compared with an average of $23,724 for the simpler operation.

“There is little evidence that these more complex operations actually improve pain relief or functional recovery,” said lead author Dr. Richard A. Deyo of the Oregon Health & Science University in Portland.

Deyo also said it is “implausible” that the number of people requiring complex spine surgery increased 15-fold in five years. He said surgeons appear to have been swayed by surgical device company marketing.

In a commentary accompanying the study in the Journal of the American Medical Association, Dr. Eugene Carragee, a surgeon at Stanford University, agreed writing “simple decompression operations rarely have well-funded advertising campaigns or well orchestrated promotions at professional meetings.”

Carragee also pointed out that surgeons stand to make more money by performing more complex operations. Medicare pays surgeons $600 to $800 for a basic decompression operation, but up to ten times more for a complex fusion procedures.

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