Spine Fusions Stopped in North Carolina

Spine Surgeons voiced fear nationwide that one of their highest paid spine procedures, spine fusions, attempting to treat degenerative disc pain, won’t be paid for by Blue Cross Blue Shield of North Carolina. Because spine surgery lobbyists have no evidence to justify fusions, they are now being denied. Poor outcomes are causing fusions to fall under scrutiny worldwide. (Reference) Many scientific articles, including the New England Journal of Medicine, and a European Spine treatment Guideline referenced an article stating: “The tide of scientific evidence seems to go against the spinal fusions in degenerative disc disease. After decades of advances in this field, the results of spinal fusions are mediocre.”

A related publication concluded, “As spine fusions stopped, spine surgeons increased their income through other spine procedures, not necessarily appropriate.” Why? Spine Journal

The average spine surgeon’s income remained $806,000/year.

In the New York Times , Dr. Richard Deyo stated: “It may be that financial disincentives accomplished something scientific evidence alone didn’t. It’s important to ask, why did the ‘need’ for fusions drop suddenly?”

An article in Becker’s Spine Review titled: ”Spine Fusions Face an Uncertain Future”, combined with  BCBS of North Carolina’s announcement, hit a nerve with many spine surgeons. Some spine surgeons deny the evidence and aggressively fight the dissemination of information to patients which debunks fusions and other unnecessary spine surgery. Now the FBI and Department of Justice are involved, wanting to inform patients of facts associated with unnecessary spine surgery, highlighted by CBS National News.

It’s clear that many spine surgeons prosper from unnecessary spine surgery, reported a Bloomberg article. The article continues: “even after studies found that fusions don’t help patients more than physical therapy, and therapy is a lot less dangerous, the number of fusions doubled in six years to 413,000 surgeries, generating $34 billion. No more…These needless surgeries have gotten little attention in the debate over U.S. health care costs”.

Dartmouth Medical School Chairman and noted spine surgeon Sohail Mirza said: “It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway. The only one who is not benefitting from the equation is the patient.” Bloomberg.

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