dave-mittlemanUsually, when I hear someone has had spinal fusion surgery, I think of it as a last resort surgeons use before permanently altering their patient’s body. I know first-hand that people will do just about anything to avoid going through that kind of surgery, including countless hours of physical therapy and simply living with levels of pain they never thought they could tolerate.

Unfortunately, it appears as though some corporations and physicians have profited on pushing for expensive fusion surgery despite high risks and costs. Unnecessary spinal surgeries cost at least $150 billion a year, according to John Birkmeyer, director of the Center for Healthcare Outcomes & Policy at the University of Michigan. Lots of this is coming at taxpayer expense through Medicare claims.

Let’s also notice who is offering some of the heaviest criticisms. I wouldn’t pay much attention if a tennis player criticized a concert pianist, but when it’s an insider of the spinal surgery community, my ears perk up.

“It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway,” said Sohail Mirza, a spine surgeon who chairs the Department of Orthopaedics at Dartmouth Medical School in Hanover, New Hampshire. “The only one who isn’t benefitting from the equation is the patient.”

Wow. So who is benefitting from this surgeries, if it’s not the patients, the people who need the care, the people who trusted their lives to the professionals? Let’s see:

Surgeons: for starters, spinal surgeons have benefitted from the fact that fusion surgeries doubled from 2002 and 2008, even in the face of evidence that physical therapy may be just as effective with much less risk in treating degenerative disc disease. The average spinal surgeon makes $806,000 a year, more than three times as much as the average pediatrician.

Medical Product Manufacturers: Medtronic, Inc., has made over $840 million last year on their Infuse product alone. Infuse was approved by the FDA in 2002, coinciding with the start of the surgery boom, as a product used to grow bone. Medtronic also just happens to pay heavy royalties to surgeons and spinal surgery firms, although they naturally claim that product usage has nothing to do with such royalties.

And just what benefit does it provide to patients? Interviews with 11 patients from Twin Cities Spine center patients found that the surgery did nothing to relieve their back pain. Nothing.

And what are the costs involved? Only potential addiction to morphine or other painkillers. One patient of the 11 noted above wound up dying from a methadone overdose when he pain became unbearable after the surgery and he couldn’t afford his regular painkillers.

Many of these surgeries are being performed on patients who have what is commonly referred to as degenerative disc disease. This means that the source of the pain is just a result in the breakdown of the soft disc in between our vertebrae.

As professionals, we all have ethical obligations to act in the best interests of our clients. I tell my young associates to treat all their clients as if they are a loved one. It pains me to see when other professionals and corporate entities don’t take that same approach.