There has been an exponential increase of spine fusions being done in the United States over the past 10 years.
Do they work? There have always been questions about the efficacy of the procedure for various conditions, but those questions have become louder recently after some significant conflicts of interest among spine surgeons have been uncovered.
In 2010, the Journal of the American Medical Association reported that between 2002 and 2007, there was a 15 fold increase in spinal fusions among Medicare patients.
Yes, the population is aging and there are more people to operate on.
But 15 fold? Recently, intense scrutiny has surfaced regarding surgeon ties to industry and monies received.
The Spinal Journal recently contradicted industry sponsored clinical research on rhBMP-2, which is a Medtronic product that is often used in fusion surgeries as a synthetic bone growth product.
Multiple studies, 13 to be exact, were scrutinized because they contained misleading and biased reports on the product.
The surgeons who performed the studies received millions of dollars for their participation.
There are about 400,000 fusions of the spin performed in the US every year, and approximately 25% of those surgeries include Infuse, which is the name of the synthetic bone growth product.
Multiple adverse events were left out of the data, and that coupled with the financial ties makes the results concerning.
Especially with the fact that the product grosses close to $800 million annually.
Spinal fusions have excellent outcomes for certain conditions, such as spinal instability and trauma.
When it comes to elective procedures such as degenerative disc disease, it really is more of a roll of the dice.
And it still has not been definitively shown if the screws and rods utilized in a lot of fusions are truly necessary.
Overall outcomes when all spinal fusion surgeries are included together range from 50 to 80% good to excellent results.
For some patients this may be a life changing outcome, for others it may leave them with a continual need for narcotics and disability.
The implants are very expensive.
If the surgery doesn't work, or only provides marginal relief, patients will need to either accept their plight in life or seek relief from a pain management center.
But the question remains as to exactly when fusion surgery is truly indicated and whether or not the benefits outweigh the risks.
Additionally, just because a spinal fusion surgery is successful doesn't mean it will always be successful.
The overall re-operation rates after fusion surgery are approximately 20% over the next decade.
Plenty of these re-operations started out with a very good outcome.
More studies need to be performed evaluating whether or not this dramatic rise in spinal fusion surgeries is warranted, who should receive a fusion surgery, and when exactly spinal instrumentation is recommended.
Otherwise, there is too much uncertainty in the operating room.
Do they work? There have always been questions about the efficacy of the procedure for various conditions, but those questions have become louder recently after some significant conflicts of interest among spine surgeons have been uncovered.
In 2010, the Journal of the American Medical Association reported that between 2002 and 2007, there was a 15 fold increase in spinal fusions among Medicare patients.
Yes, the population is aging and there are more people to operate on.
But 15 fold? Recently, intense scrutiny has surfaced regarding surgeon ties to industry and monies received.
The Spinal Journal recently contradicted industry sponsored clinical research on rhBMP-2, which is a Medtronic product that is often used in fusion surgeries as a synthetic bone growth product.
Multiple studies, 13 to be exact, were scrutinized because they contained misleading and biased reports on the product.
The surgeons who performed the studies received millions of dollars for their participation.
There are about 400,000 fusions of the spin performed in the US every year, and approximately 25% of those surgeries include Infuse, which is the name of the synthetic bone growth product.
Multiple adverse events were left out of the data, and that coupled with the financial ties makes the results concerning.
Especially with the fact that the product grosses close to $800 million annually.
Spinal fusions have excellent outcomes for certain conditions, such as spinal instability and trauma.
When it comes to elective procedures such as degenerative disc disease, it really is more of a roll of the dice.
And it still has not been definitively shown if the screws and rods utilized in a lot of fusions are truly necessary.
Overall outcomes when all spinal fusion surgeries are included together range from 50 to 80% good to excellent results.
For some patients this may be a life changing outcome, for others it may leave them with a continual need for narcotics and disability.
The implants are very expensive.
If the surgery doesn't work, or only provides marginal relief, patients will need to either accept their plight in life or seek relief from a pain management center.
But the question remains as to exactly when fusion surgery is truly indicated and whether or not the benefits outweigh the risks.
Additionally, just because a spinal fusion surgery is successful doesn't mean it will always be successful.
The overall re-operation rates after fusion surgery are approximately 20% over the next decade.
Plenty of these re-operations started out with a very good outcome.
More studies need to be performed evaluating whether or not this dramatic rise in spinal fusion surgeries is warranted, who should receive a fusion surgery, and when exactly spinal instrumentation is recommended.
Otherwise, there is too much uncertainty in the operating room.