Spinal Surgery Varies by Region in U.S.

“Nearly 80% of Americans will experience low back pain at some point in their lives, and about 30 million people a year receive professional medical care for a spine problem,” co-author Brook Martin, of the Dartmouth Institute of Health Policy & Clinical Practice, said in a college news release.

In spinal stenosis, thickening of tissue surrounding the spine affects the spinal nerves, resulting in pain, according to background information in the study. Treatments include surgery, medication, physical therapy and steroid injections, the study said.

The two types of surgery of surgery for spinal stenosis are spinal decompression and spinal fusion. In spinal decompression, doctors remove the tissue compressing the spinal nerves. In spinal fusion, surgeons join two or more vertebrae to stabilize the spine.

Spinal fusion has a higher risk of infection and readmission to the hospital, and there is no evidence that it provides greater benefit to patients, according to the news release. Even so, its use increased 67% among Medicare patients from 2001 to 2011 and it’s now more common than spinal decompression, the researchers said.

The study’s analysis of Medicare data revealed that rates of spinal decompression varied eightfold across the United States, from about 25 procedures per 100,000 patients in Bronx, N.Y., to nearly 217 procedures per 100,000 patients in Mason City, Iowa. In general, rates of spinal decompression were higher in the Pacific Northwest and northern Mountain states.