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Unneeded, riskier spinal fusion surgery on rise (medicare $$$)
AP ^ | 4/6/10 | AP

Posted on 04/06/2010 8:41:11 PM PDT by mainsail that

CHICAGO - A study of Medicare patients shows that costlier, more complex spinal fusion surgeries are on the rise — and sometimes done unnecessarily — for a common lower back condition caused by aging and arthritis.

What's more alarming is that the findings suggest these more challenging operations are riskier, leading to more complications and even deaths.

"This is exactly what the health care debate has been dancing around," said Dr. Eugene Carragee of Stanford University Medical Center.

(Excerpt) Read more at msnbc.msn.com ...


TOPICS: Crime/Corruption; Government; News/Current Events
KEYWORDS: medicare
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"You have one kind of operation that could cost $20,000 and another that could cost $80,000 and there's not good evidence the expensive one is being used appropriately in the majority of cases,"
1 posted on 04/06/2010 8:41:11 PM PDT by mainsail that
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To: mainsail that

MSNBC setting us up for when Obamacare starts turning down operations. Just like all of a sudden mammograms don’t help either.


2 posted on 04/06/2010 8:46:53 PM PDT by Wisconsinlady (.)
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To: mainsail that

Any study results about diabetic “feet being cut off” or kids’ “tonsils being cut out” unnecessarily?


3 posted on 04/06/2010 8:52:05 PM PDT by ozark hilljilly ("I was not born to be forced."- Thoreau)
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To: Wisconsinlady

That’s exactly what this is. When I had surgery in the Air Force, they wouldn’t pay for the spinal fusion I needed. It was an extremely risky 15 hour surgery with many specialists, but it got me out of a wheelchair. The only reason I was lucky enough to get the surgery done was because a relative was the VP of the AMA and he contacted the surgeon general of the Army. We’re headed for the same kind of system. Pain and not being able to walk won’t be reason enough to have a surgery because it’s too expensive and risky. Until a Congress critter has a back problem, and then they’ll get what they need to keep waddling up the capital steps and dragging us into socialism. Pigs. Nothing like having a politician decide what kind of quality of life you have.


4 posted on 04/06/2010 8:56:35 PM PDT by Cherokee Conservative (If a tree falls over in the woods, and then snaps back upright as a joke, do the squirrels laugh?)
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To: mainsail that
Surgery is not always the answer. When the gov't says Alternative treatments like naturopathy can be covered, I'll listen - as long as the doctor of Naturopathy is required, like in Florida and other states, to also be a trained physician. For ex: one of my granddaughters, when a baby, had a bad case of rhino-virus. For the next 8 years, she suffered from stomach pains after eating. Her parents took her to doctors and specialists and tests in Maine, in Nova Scotia (they're military) and Texas and the Florida.

They couldn't diagnose or help her. My daughter researched on line and printed out the symptoms of "leaky gut (Celiac disease) and took it the doctor.

She was pooh-poohed. By now, they had spent thousands of dollars and the insurance company had paid out thousands...and my little granddaughter had suffered for years.

Then one day, at a health food fair, the naturopathic doctor was offering an instant blood analysis for $50. My daughter asked him to do it on her daughter. He took a drop of blood, analyzed it, looked at her - not having been told one thing about her problems - and asked: "Does your tummey hurt after you eat, honey?"

BINGO. Celiac Disease. He prescribed a gluten free diet - and she was immediately better and has blossomed since. NO MORE TROUBLE...after years of suffering every day. And it cost $50.00.

When she took her to their next regulars doctor visit and told her about the diagnosis and results, the doctor was snippy and dismissed it with "Well, I guess if it continues to work, you'll know if he was right or not." But she was clearly affronted.

BTW, rhino-virus is a precurser of celiac - why would Some doctor along the way not have put this together?

5 posted on 04/06/2010 9:13:08 PM PDT by maine-iac7
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To: mainsail that

Eugene Caragee, by the way, is in the Army Reserves and spent a year in Iraq, about 2005, and this all over the country, and not in the Green Zone.


6 posted on 04/06/2010 9:51:21 PM PDT by Plutarch
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To: Cherokee Conservative

Unfortunately, I have an Air Force story that goes in the other direction.

I have a healthy, 27 year old friend, currently on active duty in the Air Force, who suffered a lumbar spinous process fracture (fracture of the bone that sticks out the back of the vertebra). The spinal alignment was excellent, the disk spaces were perfect. There was no other damage on X ray or CT other than that spinous process fracture. My friend could walk and bend and work out, but he did have occasional back pain. My guess is that the sharp edges of the fracture were occasionally grinding into nearby muscle and fascia, causing pain.

The Air Force sent my friend to a private surgeon who recommended that this basically healthy 27 year old have a spinal fusion (fusing the vertebrae together, and not addressing the fractured spinous process) to deal with his intermittent back pain. This surgeon apparently did not offer what I, and a bunch of orthopedic surgeons / pain management specialists (after I heard about this, I got some co-workers involved) thought would be the logical thing, namely removing the broken piece of spinous process.

As it happens, my friend did nothing, and is doing fine.

Point being: even for Air Force personnel, there has been at least one situation where spinal fusion has been on the verge of being done despite perhaps being an overly-aggressive, and perhaps completely inappropriate, surgery.

I’m not prepared to publicize a guess as to the motivation behind advising a spinal fusion to a basically healthy young man, but I will say that a number of other physicians who later reviewed the case thought that it was pretty outrageous to advise such a surgery in such a case.

I present the above to make this point: sometimes it may be appropriate NOT to have expensive surgeries. And, while I am not commenting on any particular surgeon’s motivations, one might theorize that perhaps the very cost / expense of a particular procedure might be a motivation to recommend that procedure to patients. If so, there should be a countervailing pressure to NOT perform this surgery unless it’s clinically indicated.


7 posted on 04/06/2010 10:03:41 PM PDT by Jubal Harshaw
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To: mainsail that

I had two ruptured discs and my neuro surgeon said that spinal fusion was over prescribed because the doctors make a lot of money off of them. The down side was that it moves the stresses to the next disc, and you end up with another problem and it just continues on up the spine. He removed my discs, leaving me pain free and slightly shorter. This was in 1998. For about two years I could feel the bones clicking as I walked and moved, but arthritis eventually fused them together. Still no pain and it has been ten years.
About the same time I had my surgery, ARTIFICIAL DISC surgery was taking place in other countries, France was particularly popular for Americans with money to go to to have it done. It was not yet approved in the U.S. The cool thing about artificial discs is, that it FIXES the problem. Everything we do in this country leaves you with a mechanically damaged spine but releaves the pain (sometimes).


8 posted on 04/06/2010 10:13:37 PM PDT by Boiling point (Beck / Palin 2012)
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To: Jubal Harshaw; Cherokee Conservative; mainsail that
That's crazy. Why would a surgeon want a 27 year old to undergo a fusion? I am a third generation back surgery patient, and I would do just about anything to avoid a fusion. I have an aunt who had 3 vertebrae fused when she was 38, and now just 23 years later she's having terrible pain and being treated by a pain management specialist. The other day I commented on recent picture of my aunt and told my mom that her sister seemed to be gaining lots of weight. My mom said it was due to the cortisone shots she is receiving.

Spinal fusion should be the last option after other options like physical therapy or less radical surgery has failed.

9 posted on 04/06/2010 10:26:52 PM PDT by Paleo Conservative
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To: mainsail that

Much better for “the one” or a gubmint beancounter to make that decision than your orthopedic surgeon


10 posted on 04/06/2010 10:43:56 PM PDT by Eagles6 ( Typical White Guy: Christian, Constitutionalist, Heterosexual, Redneck.)
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To: maine-iac7

I would’ve gone to a different doctor at the first pooh-pooh. Celiac is notoriously easy to deal with, and verify, via diet.


11 posted on 04/06/2010 10:54:42 PM PDT by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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To: maine-iac7

But Obamacare cuts alternative medicine. It cuts just about everything, but accupuncture, chiropractic are all cut. Obviously the Obots do not suffer from back problems.


12 posted on 04/06/2010 11:38:37 PM PDT by Semperfiwife (Can your Congressman heal you of your diseases? He thinks he can, he just passed Health CARE.)
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To: mainsail that

bookmark


13 posted on 04/07/2010 12:48:29 AM PDT by The SISU kid (I feel really homesick all the time & so do all the other aliens.....)
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To: Paleo Conservative

I had spinal fusion in 2005 and it was the worse thing ever. Almost 5 years later I am in daily pain, sometimes so bad I can’t even move about. I am in pain management, take too much Morphine everyday and see no way out of it. 42 years old and I feel like I am done.


14 posted on 04/07/2010 12:55:42 AM PDT by Pylon (Tagline: (optional, printed after your name on post):)
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To: Cherokee Conservative

Heck my sons custom seating system for his WC and WCshower chair was around 15grand.

And that is not with the new tax that is going to be added to durable med equip.

I relize a basic WC with no seating system is only about 4 grand (top of the line).

But come on if you can be free of a WC and the type of vehicle needed to transport (another huge cost) your more likely to be hired in the work force.

Sad truth in the culture of death we live in.

Two legs will get ya a job more so than 4wheels.

I am not going to fear Obama care untill it bears the sour fruit or not.


15 posted on 04/07/2010 1:45:28 AM PDT by Global2010 (We have De Humanized our Society because we have De Christianize our society. Fr.Corapi)
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To: maine-iac7

Hah. After lifelong stomach and lower gut wrenching (like to pass out) pain I changed my diet to what my body could handle and all those episodes dissapeared.

Sometimes it is just that simple, diet change.


16 posted on 04/07/2010 1:48:16 AM PDT by Global2010 (We have De Humanized our Society because we have De Christianize our society. Fr.Corapi)
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To: Jubal Harshaw

I broke two of the doo hickeys off in a horse fall/threw me.

I refused surg. at the time I went to ER (was going into shock) and along with other back issues I just changed the things in my enviroment as I cant bend forward more than a few times without going into spasm/pain.

Even the water cooler is up on a platform along with allot of the other things in our work enviroment.

It works. Cant take the time off post op to heal due to my commitment to caring for KV.

I assisted with him in an ER a month ago (had not been to a hosp for his needs in a few years) and man was my back locked up after having to bend over that low gurney for all those hours.

Still healing from that night. Worst pain I have been in in a few years.

On a high note the ER room had been remodeled and now has an overhead lift and he brings his quad sling everwhere he goes so that worked out well. Usually takes 4-5 people to tranfer/handle him due to ballistic movements.
We did it with 2-3 that night having the overhead lift.

So yeah I agree back surg is intense and the rehab/post care is essential to have the best outcome.
Not everyone has that time/dedication.

But for the fellow up post it got him out of a WC and walking cant beat that.

Case by case and allotta Prayer.


17 posted on 04/07/2010 1:59:01 AM PDT by Global2010 (We have De Humanized our Society because we have De Christianize our society. Fr.Corapi)
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To: Pylon

Wow that is really sad.

And I know you have done it all to adapt your enviroment too.

Geeze.

I dont know if you Pray but we both suffer, KV really suffers pain with a cripped body do to Cerebral Palsy, we lift are suffering up in Prayer for Mercy for the Whole world.

If you care too. Google St.Hermann the Monk born with severe CP/spina bifada/cleft palate and despite being bed bound for the most part and lifelong pain he created Hymns and musical instruments and was a scholar at math/astromony.

The foot note was interesting in that it said had he been born to a pagan he would have been left to die or if he had been diagnosed in our times he would have been aborted.

His parents could not care for him so they gave him to an order of Monks at a Monestarty.

Point being is we can do awesome things even if not as talented as Hermann the cripple with out suffering.


18 posted on 04/07/2010 2:07:54 AM PDT by Global2010 (We have De Humanized our Society because we have De Christianize our society. Fr.Corapi)
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To: Global2010

yo. hugs for global and kv.. happi1 back from the dead ^__^

lol no jager for you.

http://www.youtube.com/watch?v=H2MONFp_h2g


19 posted on 04/07/2010 2:11:25 AM PDT by happinesswithoutpeace (1.416785(71) x 10^32)
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To: Pylon

No way to un-fuse or revise the fusion? Or simply too costly?


20 posted on 04/07/2010 2:13:58 AM PDT by HiTech RedNeck (I am in America but not of America (per bible: am in the world but not of it))
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