10 key facts about spinal stenosis treatment from Dartmouth Atlas

Written by Laura Dyrda | November 03, 2014 | Print  |

Depending on where you live, your treatment for spinal stenosis could be different.

There are several factors determining patient treatment for any condition, including the patient's opinion. Factors such as age, health, surgeon experience and payer coverage all have an impact on how spinal stenosis is treated.


However, geography may be a factor. Dartmouth Atlas Project researchers found treatment varied significantly across the country in their latest installment, "Variation in the Care of Surgical Conditions: Spinal Stenosis." The region made a big impact on whether the patient underwent a lumbar decompression or not to alleviate pain.


Here are 10 key takeaways from the report:


1. The rate of spinal fusion surgeries increased among Medicare beneficiaries from 2001 to 2011, overtaking decompression as the most common surgical choice for spinal stenosis.


2. The rate of inpatient decompression varied eightfold across the country; the lowest was 25.2 procedures per 100,000 beneficiaries in Bronx, New York to 216.7 procedures per 100,000 in Mason City, Iowa.


3. The rate of spinal decompression was generally higher in the Pacific Northwest and northern Mountain states than the rest of the country.


4. The rate of fusion varied by a factor of more than 14 across hospital referral regions. The lowest was 9.2 procedures per 100,000 in Bangor, Maine and the highest was 127.5 per 100,000 in Bradenton, Fla.


5. Re-hospitalizations occurred within 30 days for 7.8 percent of the patients undergoing decompression and 13 percent of the patients undergoing complex fusion.


6. The two-year reoperation rate was 17 percent for Medicare patients undergoing spine surgery for lumbar stenosis with or without spondylolisthesis.


7. Another 25 percent of the patients were readmitted to the hospital for surgery-related complications within two years.


8. There was a greater risk of wound problems and life-threatening complications within 30 days of surgery for fusion procedures, in addition to a higher rate of all-cause repeat hospitalizations, according to the report.


9. Ten years ago, in 2004, more than $100 billion was spent in the United States on medical care associated with spine problems.


10. On average, patients with back pain have 73 percent higher healthcare expenses than patients without back problems.


More articles on spine surgery:
Does early multimodal prophylaxis impact VTE post-spine surgery? 5 key notes
What is the most important issue facing spine surgeons in 2015?
Dr. Chibuikem Akammonu joins Finger Lakes Health

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