ArticleSurgical neurology international2011
"Unnecessary" spinal surgery: A prospective 1-year study of one surgeon's experience.
Article in Surgical neurology international, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pain medication use after spine surgery: is it assessed in the literature? A systematic review, January 2000-December 2009.BMC research notes · 2015Pooled it
- [Less surgery and lower cost due to back pain in a care program with an interdisciplinary second opinion procedure : A controlled non-randomized intervention study based on claims data].Schmerz (Berlin, Germany) · 2023Article
- Unnecessary spine surgery: can we solve this ongoing conundrum?Frontiers in surgery · 2023Article
- Second opinions for spinal surgery: a scoping review.BMC health services research · 2022Article
- Second opinion in spine surgery: A scoping review.Surgical neurology international · 2021Article
- Perspective on robotic spine surgery: Who's doing the thinking?Surgical neurology international · 2021Review
- Impact of acupuncture treatment on the lumbar surgery rate for low back pain in Korea: A nationwide matched retrospective cohort study.PloS one · 2018Article
- What happened to "Patient first" and "Do no harm" medical principles?Surgical neurology international · 2018Article
- Cervico-thoracic Interspinous Bursitis Associated with Bilateral Upper-extremity Numbness: A Case Report.Cureus · 2017Article
- Second opinion for degenerative spinal conditions: an option or a necessity? A prospective observational study.BMC musculoskeletal disorders · 2017Observational
- Overtreatment in the United States.PloS one · 2017Article
- Spinal Cord Stimulation in Failed Back Surgery Syndrome: Review of Clinical Use, Quality of Life and Cost-Effectiveness.Asian spine journal · 2016Review
- Second opinion in spine surgery: a Brazilian perspective.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2015Article
- Not by bread alone: shortcomings of the pay-for-performance approach.Clinical orthopaedics and related research · 2014Article
- Neurosurgery: A profession or a technical trade?Surgical neurology international · 2014Article
- Complications due to the use of BMP/INFUSE in spine surgery: The evidence continues to mount.Surgical neurology international · 2013Article
- Are recommended spine operations either unnecessary or too complex? Evidence from second opinions.Surgical neurology international · 2013Article
- The value of "another" opinion for spinal surgery: A prospective 14-month study of one surgeon's experience.Surgical neurology international · 2012Article
- How much medicine do spine surgeons need to know to better select and care for patients?Surgical neurology international · 2012Article
- Multiple operations on the same patient.Surgical neurology international · 2012Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are marked disparities in the frequency of spinal surgery performed within the United States over time, as well as across different geographic areas. One possible source of these disparities is the criteria for surgery.
methodsDuring a one-year period [November 2009-October 2010], the senior author, a neurosurgeon, saw 274 patients for cervical and lumbar spinal, office consultations. A patient was assigned to the "unnecessary surgery" group if they were told they needed spinal surgery by another surgeon, but exhibited pain alone without neurological deficits and without significant abnormal radiographic findings [dynamic X-rays, MR scans, and/or CT scans].
resultsOf the 274 consults, 45 patients were told they needed surgery by outside surgeons, although their neurological and radiographic findings were not abnormal. An additional 2 patients were told they needed lumbar operations, when in fact the findings indicated a cervical operation was necessary. These 47 patients included 21 [23.1%] of 91 patients with cervical complaints, and 26 [14.2%] of 183 patients with lumbar complaints. The 21 planned cervical operations included 1-4 level anterior diskectomy/fusion [18 patients], laminectomies/fusions [2 patients], and a posterior cervical diskectomy [1 patient]. The 26 planned lumbar operations involved single/multilevel posterior lumbar interbody fusions: 1-level [13 patients], 2-levels [7 patients], 3-levels [3 patients], 4-levels [2 patients], and 5-levels [1 patient]. In 29 patients there were one or more overlapping comorbidities.
conclusionsDuring a one-year period, 47 [17.2%] of 274 spinal consultations seen by a single neurosurgeon were scheduled for "unnecessary surgery".
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