Reduced mortality and lower treatment costs seen for surgical treatment versus nonsurgical treatment
By Elana Gotkine HealthDay Reporter
MONDAY, Jan. 30, 2023 (HealthDay News) — For patients with stenosis with or without spondylolisthesis, surgical treatment is associated with significantly lower mortality and total medical payments at two years compared with nonsurgical treatment, according to research published online Jan. 12 in the Journal of Bone and Joint Surgery.
Raymond W. Hwang, M.D., from the New England Baptist Hospital in Boston, and colleagues conducted a retrospective review of the Medicare National Database Fee for Service Files from 2011 to 2017 for patients with lumbar stenosis, with and without spondylolisthesis (61,534 and 83,813 patients, respectively). Mortality, spine-related health care utilization, and two-year total Medicare payments were compared for patients undergoing surgical and nonsurgical treatment.
The researchers found that compared with matched patients undergoing nonsurgical treatment, surgical treatment was associated with 28 percent lower two-year mortality. Patients with stenosis alone or with stenosis undergoing laminectomy and with stenosis and spondylolisthesis undergoing laminectomy with or without fusion had significantly lower total Medicare payments compared with those undergoing nonsurgical treatment. When fusion or laminectomy was compared to combined fusion and laminectomy, there was no significant difference in mortality observed. However, significantly lower two-year payments were seen for laminectomy alone when treating stenosis with or without spondylolisthesis.
“It is important to emphasize that, although we demonstrated significant associations between certain surgical treatments and outcomes, the causal inference that these treatments were responsible for the improved outcomes has not been proven,” the authors write.
Several authors disclosed financial ties to the medical technology industry.
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