Cost-effectiveness of Spine Fusion Questioned in Dartmouth-led Study

Dartmouth College Office of Public Affairs • Press Release
Posted 12/16/08 • Media Contact: Deborah Kimbell • (603) 653-3602

Rates of spinal fusion have increased by more than 250 percent in the last 15 years. But is the surgery cost-effective? New research published in the December 16th issue of the Annals of Internal Medicine suggests that for patients with spinal stenosis with associated slipped vertebrae, the benefits of the fusion procedure are not enough to offset the costs.

Lumbar spine fusion, in which two or more vertebrae are permanently joined to decrease spine instability, accounts for more than 1/3 of all back surgeries in the United States. Between 1993 and 2004, the number of spine fusions and the associated costs rose dramatically. In 2004, spine fusion procedures totaled $16.9 billion.

“This study is significant because it is the first to systematically track people’s health care expenditures and health outcomes for these common and costly conditions,” said lead author Anna N.A. Tosteson, ScD. “Given the tremendous increase in the number of spinal fusion procedures, the question of cost-effectiveness has critical implications for the health care system.” More…