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Lower Spine News

Care and Cost of Treating a Herniated Disc

How much do you think it costs to have surgery for a herniated disc? $1000? $10,000? That's not a trick question but answering it can get tricky. Do you include the cost of conservative care that failed first before the patient had the surgery? That would be around $4700 according to this study from the Johns Hopkins Spinal Column Biomechanics and Surgical Outcomes Lab in Baltimore, Maryland.

If you just calculate the cost of removing one disc surgically, then we're talking about $5,000. That's the surgeon's fee for a minimally invasive procedure called microdiscectomy. With all the other costs of hospitalization, anesthesia, operating room, and post-operative care, the bill comes to about $42,500.00. But sometimes patients end up with severe pain from spine degeneration at the site of the disc removal. Then they need further surgery with a possible spinal fusion. That can be a cool half-million dollars per patient.

Surprised? Substantial health care costs aren't the norm for single-level discectomy but this Johns Hopkins patient and cost analysis shows it happens in about nine per cent of the cases at their institution. The researchers reveal how often this happens and uncover the hidden costs associated with persistent back pain requiring surgery for spine instability following a discectomy.

They got this information by reviewing institutional billing and accounting records for 111 patients. Each patient was diagnosed with a single-level lumbar disc herniation. Low back and leg pain (sciatica) were the main symptoms but weakness, numbness, and tingling were also reported. Symptoms were severe enough to need surgical intervention because conservative care was unsuccessful. X-rays and other imaging studies showed degeneration and/or instability severe enough to warrant further surgery.

The authors concluded that most patients who have a microdiscectomy procedure for a herniated disc have a very successful outcome and no further treatment is needed. For those who develop back pain later, conservative care seems to clear up any problems. But in a small number of patients, significant health care costs are incurred when additional surgery is needed. Not all of the billed costs are paid or collected. And the cost of pain medications or missed work was not factored in.

Comparing the results of this study at one hospital, the average costs seem in line with other places. The number of patients affected (referred to as the incidence) is about the same as other places as well. Given the high costs of additional surgery, the authors recommend trying conservative care first for any patient who reports postdiscectomy back pain. In fact, they suggest this step for at least three months before even repeating X-rays, MRIs, or other imaging studies. The idea is to reduce the costs associated with this problem while still providing effective treatment.


Scott L. Parker, BS, et al. Long-Term Back Pain After a Single-Level Discectomy for Radiculopathy: Incidence and Health Care Cost Analysis. In Journal of Neurosurgery: Spine. February 2010. Vol. 12. No. 2. Pp. 178-182.

02/11/2010

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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