Claims Data Document Futility of Lumbar Fusion

March 12, 2014

(AAOS2014) A study of Cigna claims documents unmistakeably what happens to patients after lumbar fusion for degenerative conditions: Continued pain.

Analysis of claims for 1,422 patients undergoing lumbar fusion surgery for degenerative spinal conditions has produced a very clear image of the challenge facing these patients and doctors who treat them. The data confirm ample evidence from the medical literature of the limited value of the surgical  procedure.

In the two years after surgery:

•  29%  had lumbar injection procedures
•  32%  used some form of therapy (chiropractic, acupuncture, etc.) for more than 90 days
•  63%  were taking narcotics more than a year post-op
•  95%  who had been on narcotics before surgery continued taking them afterwards
•  98%  were taking multiple classes of pain medications

This was the outcome of claims from patients who had lumbar fusion treated for ICD-9 diagnostic codes consistent with a degenerative condition between January and September 2009.

Those patients taking postoperative narcotics averaged three different brand-name narcotic prescriptions, reported David Mino MD MPH, Cigna's national medical director for orthopedic surgery and spinal disorders  at the American Academy of Orthopaedic Surgeons annual meeting in New Orleans.

Providers need to share data and collaborate to find integrated, patient-centered solutions to the unsolved problem of lumbar pain, he concluded.