This article caught my attention because of the sheer numbers involved. In addition, I recently saw a patient who's doctor recommended surgery for his chronic low back pain. After coming to me for a second opinion, I suggested a more conservative approach of Chiropractic therapy, stretching, exercise and simple home care. After three weeks, he is already feeling better than he has been in the last two years. Now he's grateful he tried Chiropractic before opting for surgery like his doctor had suggested. (The surgery suggested would have involved a spinal fusion, mentioned in this article, that would have surgically combined two separate vertebrae in his spine into one)
Now on to the article. This piece was published in the Journal of the American Medical Association. In it, it was revealed that the use of complex spinal surgery to treat back pain has exploded in the last six years. Even though these operations are more expensive and riskier than simpler therapy, and not necessarily more effective.
"It was a bit of a surprise to see how big the increase was," said Dr. Richard A. Deyo, professor of family medicine and internal medicine at the Oregon Health and Science University and lead author of a report published April 7 in the Journal of the American Medical Association. "A 15-fold increase over a short period of time was more than we expected." Several possible explanations exist for the increase, money among them, Deyo said. "There are financial influences at play," he said. "You get paid more for complex procedures."
Deyo and his associates looked at a particular problem, Spinal Stenosis. This is when the 'holes' in your back, where nerves travel through get progressively smaller and smaller. Without intervention, the smaller the hole gets, the more irritation and compression it can put on the nerve passing through. Eventually this can be a huge problem not only causing pain but loss or function, muscle wasting and numbness, just to name a few.
Deyo and his team looked at Medicare claims from 2002 to 2007. Over that period, they found that surgery for spinal stenosis actually decreased slightly. However, of the operations that were done, complex surgery rates shot up a staggering 15 times higher! Meaning, in spite of more conservative treatment options, including simpler surgery, doctors were resorting to complicated surgery far more often. Not surprisingly, the study also found related hospital costs over the same time period increased 40%.
The costs of simpler surgical options were reported to be $23, 724 but the costs of more complex spinal fusion surgeries were found to be $80, 888. In addition, patients who underwent complex surgeries spent two more days in hospital and were 3X more likely to encounter a life-threatening complication related to surgery.
Now the big question remains, "...was it worth it?". The surgical literature does not appear to justify the extra cost and hazard of the complex procedures for most people, Deyo said. "Most of the evidence suggests that in terms of pain relief and functional recovery, there is not much advantage in terms of complex procedures," he said. "There is even a possibility that the net benefit of surgery is lessened because of this."
Wow. Now I know many people will counter this study occurred in the states and the results would likely be different in Canada. But the question is, "... are you sure?" With our population aging and the already accepted lifetime incidence of low back pain to be near or above 80%, isn't it likely that doctors will suggest surgery more and more?
I suggest that the answer is Yes. Unless we start looking at other options like Chiropractic. That's right, not only has Chiropractic been proven as both effective and safe but Chiropractic by it's very nature is Preventative!
As everybody knows, an ounce of prevention is worth a pound of cure! So if you've been suffering from back issues, go see a Chiropractor. Not only can you find relief but you can learn strategies and techniques to keep you back and body in good shape, hopefully avoiding a costly surgery later!
In the Commercial Drive neighborhood of East Vancouver? Drop in and see Dr. Chan or visit his website here; COMMERCIAL DRIVE - EAST VANCOUVER CHIROPRACTOR; DR. DOMINIC CHAN DC
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