Researchers analyzed a commercial insurance policy’s impact in North Carolina restricting lumbar fusions for specific indications, according to a Spine study.
The study included data from the State Inpatient Database of North Carolina between 2005 and 2012, as well as the Nationwide Inpatient Sample. Researchers noted the change in rates of lumbar fusion surgery for disc herniation, spinal stenosis, spondylolisthesis and revision procedures.
Here are five observations:
1. Following the policy change on Jan. 1, 2011, researchers found a significant decrease in the number of lumbar fusions for disc herniation.
2. Elective lumbar fusion surgeries (per 100,000 North Carolina residents) increased from 103.2 in 2005 to 120.4 in 2009. By 2012, elective lumbar fusion surgeries decreased to 101.9.
3. The number of lumbar fusion surgeries for spinal stenosis, spondylolisthesis and revision procedures did not drastically increase, despite the general increasing trend.
4. Researchers found decompression without fusion increased.
5. Researchers concluded the insurance policy change resulted in a decreased number of lumbar fusions for "indications with less evidence of effectiveness without changing rates for other indications or resulting in an overall reduction in spine surgery."