Another study done in Utah, again on the Medicare Population
showed Utah laminectomy and discectomy rates were at least 20%
higher than the U.S. average. In this study they reason of increased
number of surgeries was the diagnosis of spinal stenosis and not the
number of surgeons.
Since managed care took over the number of surgeries has been
declining in that population. Maybe the patients in managed care
have better backs?
In 1998 yet another study was done this time in Washington state which
looked at complication rates in back surgery. Spinal fusion was associated with wider
surgical exposure, more extensive dissection, and longer operative
times than lumbar surgery without fusion, and previous studies have
shown higher complication rates and hospital charges associated with
these more complex procedures. In elderly patients, spinal fusion
operations were associated with higher mortality rates than laminectomy or discectomy alone, and reoperation rates were not
lower. they found higher number of complicates were associated with
fusion then with a simple laminectomy.
In most people the back pain will go away within four weeks thus
a person may want to wait on conservative treatments. Laminectomy
which is simple removal of bone done for spinal stenosis is better
then Laminectomy and Fusion. In a Fusion the upper and lower
Vertebra are joined together. This is done to reduce the movement of
the individual vertebrae.
Yet another study was done in Darthmouth this time comparing
medical treatments to surgical treatments. They found that surgery
only offered a short-term benefit. The long-term outlook for both
treatments was similar.
My own personal experience in many patients who had failed
back surgeries was that if they were given trigger point treatment
they improved.
So if you have back pain there is always a simple treatment.
Spinal stenosis is a medical emergency and needs to be surgically
treated , or can result is severe paralysis.
Following is another study :
please also see Back Pain types
| Spine. 1994 Jun
1;19(11):1201-6. |
|
An international comparison of back surgery rates.
Cherkin DC
Department of Health Services, University of Washington, Seattle.
SUMMARY OF BACKGROUND DATA. Although high geographic variation in
back surgery rates within the United States have been documented,
international comparisons have not been published. METHODS. The
authors compared rates of back surgery in eleven developed countries
to determine if back surgery rates are higher: 1) in the United
States than in other developed countries, 2) in countries with more
neurologic and orthopaedic surgeons per capita, and 3) in countries
with higher rates of other surgical procedures. Data on back surgery
rates and physician supply were obtained from health agencies within
these eleven countries. Country-specific rates of other surgical
procedures were available from published sources. RESULTS.
The rate
of back surgery in the United States was at least 40% higher than in
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 orthopaedic and neurosurgeons in the country.
Countries with high back surgery rates also had high rates of other
discretionary procedures such as tonsillectomy and hysterectomy.
CONCLUSIONS. These findings illustrate the potentially large impact
of health system differences on rates of back surgery. Better
outcome studies, however, are needed to determine whether Americans
are being subjected to excessive surgery or if those in other
developed countries are suffering because back surgery is
underutilized.
PMID: 8073310 [PubMed - indexed for MEDLINE]
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