Dr Stitzel

Scoliosis surgery cost/benefit ratio?

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by , 02-23-2012 at 10:08 PM (9073 Views)
Quote Originally Posted by DrStitzel View Post
By Josh Woggon DC

Does the outcome of scoliosis surgery justify the rising cost of the operation? Doctors from the Department of Orthopedic Surgery at the University of Pittsburgh Children's Hospital presented a paper at the 2009 annnual meeting of the Pediatric Orthopedic Society of North America in Boston. This paper was recently accepted by the Journal of Pediatric Orthopedics.

In this study, the researchers questioned whether the newer, more expensive systems of spine fusion used to treat scoliosis today justify their higher price tags with better outcomes for the patient. Their conclusion is definitive:

"Unfortunately, patient outcomes when the latest, most expensive implants are used are not significantly different from outcomes when older, less expensive implants are used. Patient outcomes have not improved in proportion to the increase in costs. Outcomes from the newest, all pedicle screw constructs are not significantly better than outcomes from the older, less expensive hybrid constructs."

This information confirms what other research articles have suggested; newer methods of scoliosis surgery do not necessarily offer substantially improved outcomes than the older systems. The end goal is the same: the biomechanical integrity of the spine is sacrificed and rather than achieving a true resolution of the condition, one problem exchanged for another.

Spinal fusion as a treatment for scoliosis, regardless of the system used, is not supported by research:

"No long-term, prospective controlled studies exist to support the hypothesis that surgical intervention for AIS is superior to natural history. There is no medical necessity for surgery based upon the literature."

(Westrick ER & Ward WT: Adolescent idiopathic scoliosis: 5-year to 20-year evidence-based surgical results. J Pediatr Orthop 2011 Jan-Feb;31(1 Suppl):S61-8.
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