Regional Variations in Low Back Surgery is Due to 'Surgeon Enthusiasm'
Surgeons in certain areas are more likely to recommend surgery to treat low back problems and those differences in 'surgeon enthusiasm' are a major factor in driving regional variations in spinal surgery rates. The study was published in an issue of Spine.
In contrast, variations in spinal surgery are not related to enthusiasm among patients and primary care doctors. Study leader, Dr. Samuel Bedermen, writes, "Strategies targeting surgeon practices may reduce regional variation in care and improve access disparities."
Using Ontario healthcare databases, Dr. Bedermen and fellow researchers examined data on more than 50,000 surgeries performed for degenerative dis3ease of the lumbar spine between 2002 and 2006. In Ontario, as in the United States, there are pockets of unexplained variations in the spinal surgery rate.
Differences in the back rate among Ontario counties were compared with a prior survey where surgeons, family doctors, and patients with back conditions were asked to relate their preferences for spinal surgery. Presented with different scenarios, surgeons were then asked whether they would recommend surgery, family doctors whether they would rate surgery appropriate, and patients whether they would consider surgery.
The results demonstrate that there was a correlation between surgeon enthusiasm in counties with higher rates of spinal surgery. Comparing the top fourth and bottom fourth of surgeon enthusiasm, there was a 20 percent difference in surgery rates.
Prior studies using Medicare data have also found large variations in lumbar spine surgery rates across U.S counties. These variations elicit important concerns: if surgery rates are inflated, then some patients may be receiving unnecessary surgery and health care resources are being wasted. If surgery rates are too low, then some patients who may benefit from spinal surgery aren’t receiving it.
Dr. Bederman and his fellow researchers are calling upon further research to determine why surgeons vary in their enthusiasm for surgery especially for conditions where there’s strong scientific evidence for effectiveness like slipped vertebrae and spinal canal narrowing. The authors conclude, "With a better understanding of reasons for practice variation, we may be able to modify variation, reduce costs, and improve access to care."
Disclaimer
Featured Doctors
Skull Base Surgery Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Hip Pain Specialist New Jersey
Damon Noto, MD
Spine & Joint Center
777 Terrace Avenue, 4th Floor
Hasbrouck Heights, NJ 07604
Call: 866-385-8138
Herniated Disc Westchester, NY 10530
Bennie Chiles
Westchester Spine and Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Radiosurgery Westchester & Rockland
Bennie Chiles III
Westchester Spine and Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Pediatric Neurosurgery Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Knee Pain Specialist New Jersey
Damon Noto, MD
Spine & Joint Center
777 Terrace Avenue, 4th Floor
Hasbrouck Heights, NJ 07604
Call: 866-385-8138
Neuro-Oncology Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Neurosurgeon Westchester, NY 10530
Bennie Chiles
Westchester Spine and Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Cerebrovascular Surgery/ Endovascular Surgery Westchester, NY
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Stereotactic Radiosurgery Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Neuro Oncology Westchester & Rockland
Bennie Chiles III
Westchester Spine & Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Back Pain Westchester, NY
Bennie Chiles III
Westchester Spine and Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Neurosurgery/ Neurosurgeon Rockland, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Spine Surgeon Westchester, NY
Bennie Chiles
Westchester Spine and Brain Surgery, PLLC
280 N. Central Ave Suite 235
Hartsdale, NY 10530
Call: 914-332-0396
Arthritis Doctors Bergen County
Damon Noto, MD
Spine & Joint Center
777 Terrace Avenue, 4th Floor
Hasbrouck Heights, NJ 07604
Call: 866-385-8138
Neurosurgery/ Neurosurgeon Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Epilepsy Surgery Westchester, New York
Neurological and Spine Surgery Associates, P.C.
Neurological and Spine Surgery Associates, P.C.
19 Bradhurst Ave., Ste. 2800
Hawthorne, NY 10532
Call: (888) 766-1480
Minimally Invasive Spinal Disc Surgery New Jersey
Damon Noto, MD
Spine & Joint Center
777 Terrace Avenue, 4th Floor
Hasbrouck Heights, NJ 07604
Call: 866-385-8138
Shoulder Pain Specialist New Jersey
Damon Noto, MD
Spine & Joint Center
777 Terrace Avenue, 4th Floor
Hasbrouck Heights, NJ 07604
Call: 866-385-8138
Specialities
- Acupuncture
- Alternative Medicine
- Bariatric Surgery
- Breast Cancer
- Breast Surgery
- Cancer Treatment
- Cardiology
- Chiropractic
- Cosmetic Dentistry
- Cosmetic Surgery
- Dentistry
- Dermatology
- Endocrinology
- Facial Enhancement
- Fertility Treatment
- Foot Specialist
- Foot Surgery
- Gastroenterology
- General Surgery
- Geriatrics
- Hair Replacement
- Hematology
- Infectious Diseases
- Infertility Treatment
- Integrative Medicine
- Internal Medicine
- LASIK
- Laser Hair Removal
- Medical Editorial Board
- Medical Spa
- Medical Testing
- Neurology
- Neuropathy
- Nursing Home Services
- Nutrition and Diet
- Obstetrician & Gynecology
- Oncology & Cancer
- Oncology Center
- Ophthalmology
- Orthopedic Surgery
- Orthopedics
- Pain Management
- Physical Therapy
- Plastic Surgery
- Podiatry
- Spinal Decompression
- Spine Surgery
- Sports Medicine
- Stem Cell Therapy
- Thoracic Surgery
- Vascular Surgery
- Vein Surgery
- Weight Loss