Higher Complication Rate for Older Spine Surgery Patients
Complex Fusions Carry Higher Risk, Compared to Decompressions
Older patients who have invasive spinal fusions to treat severe lumbar spinal stenosis experience a higher risk of complications and have higher medical expenses than patients who have decompression surgery (such as a laminotomy or laminectomy, according to a study published in the April 7, 2010, issue of the Journal of the American Medical Association.
The goal of the study was to determine whether the risk of spine surgery complications was connected to the complexity of the surgery in older patients. The study focuses on patients with severe lumbar spinal stenosis, as the most recent growth in spinal surgery is in patients with that condition.
The research team analyzed Medicare claims between 2002 and 2007. Though the number of total spine surgeries declined during that period, the rate of complex spinal fusion surgeries surged 15-fold. (Complex spinal fusions are procedures that involve at least 3 disc levels or combine anterior and posterior approaches.)
Compared to patients who received only a decompression, the patients who underwent a complex spinal fusion were twice as likely to experience surgical complications. The complex fusion patients were also more likely to be re-hospitalized within a month of the procedure.
Moreover, the researchers discovered that an average complex fusion costs nearly $81,000, compared to nearly $24,000 for an average decompression surgery.
Though the study highlights the increased risk of complications and higher cost of complex spinal fusions in older patients, it did not consider whether complex spinal fusions actually reduced pain or improved mobility, compared to decompression surgery. To fully compare the effectiveness of spinal fusion versus decompression, more studies must be conducted.
If you'd like to learn more about this research, you can read the abstract here.