Spinal Fusion Surgery Over-used

National survey data indicate that the number of spinal fusion operations rose 77 percent between 1996 and 2001, in contrast with hip replacement and knee arthroplasty, which increased 13 percent to 14 percent during the same period. In a Sounding Board article in the Feb. 12 issue of the New England Journal of Medicine, Dr. Richard Deyo, professor of medicine and of health services, and Dr. Sohail Mirza, associate professor of orthopedics, recommended more restraint in the use of spinal fusion.

“It's unclear whether some patients really benefit from this surgery, compared to rehabilitative approaches, such as education and graded exercise training,” Deyo said. “Additionally, the complication rate for spinal fusion is relatively high compared to both other types of back surgery and non-surgical treatment.”

He added that the rapidly rising rate of surgery and expense of the operation, which can cost over $34,000 on the average, raise additional concerns.

The article's authors note that although spinal fusion may be the correct answer for some degenerative spine disorders, it may be over-used. They recommend that research shift from examining how to perform spinal fusion to examining which patients should be candidates for this surgery.