According to government data, more than 465,000 spinal fusions were performed in the United States in 2011. Some experts say that a portion of them, perhaps as many as half, were performed without good reason. The government study of Medicare billings showed that financial incentives for doctors may be one of the reasons for a rapid rise in spinal fusion surgery.
A study, conducted by the Office of Inspector General of the Department of Health and Human Services, focused on the extent of companies that are owned by physicians and sell equipment for spinal fusions; the equipment can cost more than $11,000 per spinal fusion. According to a study by the Office of Inspector General, nearly one in five spinal fusions sampled in the study involved equipment purchased from distributors that were co-owned by physicians. The report also showed, six months after a hospital began to purchase spinal devices from a physician-owned company, the number of spinal fusions performed jumped 21 percent on average, more than twice as fast as at other hospitals. Doctors who are investors in such companies stand to benefit when more spinal fusions are performed, according to a report that was released last month.
According to federal figures, the rate of spinal fusion surgery has risen six fold in the United States over the past 20 years. The expensive procedure, which involves the joining of two or more vertebrae, has become even more common than hip replacement. Also, Americans are far more likely to undergo the procedure than people from other countries.
Some doctors believe a simpler procedure known as a decompression often offers patients as much benefit as a fusion and poses fewer risks and complications. But the decompression might yield a surgeon roughly $1,000, while a complex fusion would garner as much as $6,000.
As U.S. medical costs have risen, questions about unnecessary treatment have become frequent. By some estimates, Americans are spending billions every year on unnecessary surgery and other medical care.