A long article in today’s New York Times raises questions about the merits of spinal fusion surgery, a procedure many Social Security Disability claimants undergo each year:
” . . . a number of researchers say there is little scientific evidence to show that for most patients, spinal fusion works any better than a simpler operation, the laminectomy. And laminectomies get patients out of the hospital and back to their daily routine much faster. Some people, experts add, would be better off with no surgery at all. Even doctors who favor fusions say that more research is needed on their benefits.”
The article suggests that Medicare payments (which pay up to four times as much for spinal fusions as laminectomies) may drive the decision to recommend fusion in many cases. It also cites the influence of fusion hardware manufacturers
“The reality of it is, we all cave in to market and economic forces,” said Dr. Edward C. Benzel, a spine surgeon who is chairman of the Cleveland Clinic Spine Institute. Though doctors, as a rule, should favor the least complicated treatment – with surgery being the last resort – Dr. Benzel estimated that fewer than half of the spinal fusions done today were probably appropriate. He described the current system of paying doctors as “totally perverted.”
The article also includes this graphic illustrating the difference between a fusion and a laminectomy.
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