I recently read an article summarizing a study that showed that risky and unnecessary back surgeries are costing Americans billions in health care costs. As a chiropractor whose practice focuses more on functional neurology and nutrition, I have rarely posted about traditional chiropractic. This was too important to pass up.
The study of Medicare patients showed that costlier, more complex spinal fusion surgeries are on the rise — and sometimes done unnecessarily — for a common lower back condition caused by aging and arthritis.
What is even scarier is that the study showed that these surgeries are leading to more hospitalizations and even death in some cases.
The cost to Medicare, just for the hospital charges for the types of back surgery reviewed is about $1.65 billion a year, according to the researchers. Medicare is a government program that is funded by you and me. Failed back surgeries are one major reason health care is so expensive in this country.
The study examined two types of back surgeries – decompression and fusion.
In a decompression procedure, the simplest method in the Medicare study, a surgeon cuts away part of the bone that’s painfully pressing on nerves. It can cost about $30,000 in hospital and surgeon fees.
For a fusion, a surgeon binds two or more vertebrae together using a bone graft, with or without plates and screws. The researchers defined a complex fusion as one involving three or more vertebrae or more than one side of the spine. Fusions cost $60,000 to $90,000.
The researchers analyzed data on more than 32,000 Medicare patients who had one of the three types of surgeries in 2007.
The study found that fusions were often done in patients that had little or no need for the more complex surgery. Fusion is significantly more complicated and leads to more secondary issues.
The lead author on the study concludes that aggressive marketing of devices used in complex fusions is likely playing a role in the increase in these types of surgeries. The marketing includes ads in medical journals and lectures by surgeons on the payroll of device manufacturers. There is little evidence to support that they are safe or effective for these patients.
The lead author also concluded that patients should ask their doctors about alternatives to complicated operations. Could steroid injections and physical therapy be tried? While I applaud him for recognizing that there are alternatives he failed to mention the most successful one, chiropractic.
Chiropractic has been shown in many studies to be very effective in managing low back pain. It has also been shown to be far more cost effective than surgery. Think about it this way; a chiropractic visit may cost about $100. This would likely include an adjustment to correct any fixations in the spine and some other form of therapy. This might include stretching, neuromuscular work, electrical stim, hot or cold packs or rehabilitative exercises/instruction.
At $100 a visit you could get 900 office visits to the chiropractor or 1 spinal fusion. To me the choice is obvious. You certainly wouldn’t need 900 office visits to your chiropractor to get better, but it puts it into perspective for you.
On top of that, there is no garauntee that your back surgery is going to work and the risk of serious complication or death is relatively high. There is no risk of death or serious complication from chiropractic treatment of the low back.
The study showed that many people are being given unnecessary back surgeries. They looked at Medicare patients only. Recently patients in “The Medicare Demonstration Project” gave chiropractors high marks for satisfaction. Obviously Medicare patients are finding relief with chiropractic care.
The Medicare Demonstration Project revealed the long-awaited results from a congressionally mandated pilot project testing the feasibility of expanding chiropractic services in the Medicare program.
When patients were asked to rate their satisfaction on a 10-point scale, 87 percent of patients in the study gave their doctor of chiropractic a level of 8 or higher. What’s more, 56 percent of those patients rated their chiropractor with a perfect 10.
The very same population of people were studied in these two studies. While not everyone in the Medicare Demonstration Project had the same conditions as the people in the study that examined back surgeries, surely there was some overlap. What can be said for sure is that the over all population of people studied between the two were very similar because they were all Medicare patients.
In order to solve the health care crisis in this country, “alternative” therapies that are effective and certainly more cost effective need to be implemented. Chiropractic fits that bill. It is clear that people who would benefit from having more access to chiropractic would be satisfied with the care they received. It is time for Medicare to reexamine what they choose to cover if they want to save the American people their hard earned money.