Our Summary

This study examined the trends in rates and costs of lumbar fusion procedures in the US from 2004 to 2015. Lumbar fusion is a type of back surgery that is used to treat different spinal conditions. The study found that the number of these surgeries increased by 62.3% over the 12 year period. The greatest increase was seen in patients aged 65 or older. The conditions that saw the most increase in the use of this surgery were spondylolisthesis (a condition where a bone in the spine slips out of place) and scoliosis (a condition where the spine curves to one side). These two conditions, along with disc degeneration, herniation, and stenosis (narrowing of the spinal canal), accounted for 42.3% of all the lumbar fusion surgeries in 2015. The total cost of these surgeries increased by 177% over the 12 years, exceeding $10 billion in 2015, with an average cost of over $50,000 per surgery. The study also noted that the use of this surgery for conditions where it is less effective has slightly decreased in recent years.

FAQs

  1. What is lumbar fusion and what conditions does it treat?
  2. How much has the use and cost of lumbar fusion surgeries increased from 2004 to 2015?
  3. What conditions accounted for the majority of lumbar fusion surgeries in 2015?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal fusion is to thoroughly discuss the potential risks and benefits of the surgery with your healthcare provider. It is important to have a clear understanding of what to expect before, during, and after the procedure, as well as the potential outcomes and complications that may arise. Additionally, following post-operative instructions, participating in physical therapy, and maintaining a healthy lifestyle can help optimize the success of the surgery and improve recovery outcomes.

Suitable For

Patients who are typically recommended spinal fusion surgery include those with severe back pain, instability in the spine, degenerative disc disease, herniated discs, scoliosis, spondylolisthesis, spinal stenosis, and other spinal conditions that have not responded to conservative treatments such as physical therapy, medications, and injections. The decision to undergo spinal fusion surgery is typically made after a thorough evaluation by a spine specialist and consideration of the patient’s overall health and medical history.

Timeline

Before spinal fusion:

  1. Patient experiences chronic back pain, numbness, weakness, or other symptoms related to a spinal condition.
  2. Patient undergoes various conservative treatments such as physical therapy, medications, injections, and lifestyle modifications.
  3. If conservative treatments are not effective, patient and their healthcare provider decide that spinal fusion surgery is necessary.
  4. Patient undergoes pre-operative evaluations, tests, and consultations to prepare for the surgery.

After spinal fusion:

  1. Patient undergoes spinal fusion surgery, where the vertebrae are fused together to stabilize the spine and alleviate symptoms.
  2. Patient stays in the hospital for a few days for monitoring and recovery.
  3. Patient begins a rehabilitation program to regain strength and mobility.
  4. Patient may experience some discomfort or pain during the initial recovery period.
  5. Over time, patient gradually resumes normal activities and experiences improvement in symptoms.
  6. Patient continues to follow-up with their healthcare provider for monitoring and adjustments as needed.

What to Ask Your Doctor

  1. What specific condition do I have that is necessitating spinal fusion surgery?
  2. What are the potential risks and complications associated with spinal fusion surgery?
  3. How long is the recovery process and what can I expect in terms of pain management?
  4. Are there alternative treatments or non-surgical options that I could consider before proceeding with spinal fusion surgery?
  5. What is the success rate of spinal fusion surgery for my particular condition?
  6. How many spinal fusion surgeries have you performed and what is your success rate?
  7. Will I need physical therapy or rehabilitation after the surgery?
  8. How long will I need to be off work or restricted in my activities after the surgery?
  9. What type of hardware or implants will be used during the surgery and what are the potential long-term effects of these devices?
  10. What is the expected outcome in terms of pain relief and improvement in mobility after the surgery?

Reference

Authors: Martin BI, Mirza SK, Spina N, Spiker WR, Lawrence B, Brodke DS. Journal: Spine (Phila Pa 1976). 2019 Mar 1;44(5):369-376. doi: 10.1097/BRS.0000000000002822. PMID: 30074971