Paying for Spinal Stenosis?


Recently the Journal of the American Medical Association published a study concerning trends in surgery for lumbar spinal stenosis. The study group was a medicare population but its findings have application in our workers compensation cases, as well. Here are some salient details. “ln recent decades, the fastest growth in lumbar surgery occurred in older patients with spinal stenosis. Trials indicate that for selected patients, decompressive surgery offers an advantage over nonoperative treatment but surgeons often recommend more invasive fusion procedures” (Emphasis added). “OveraIl, surgical rates declined slightly from 2002-2007, but the rate of complex fusion procedures increased 15-fold… Life-threatening complications increased with increasing surgical invasiveness, from 2.3% among patients having decompression alone to 5.6% among those having complex fusions.”

Surgery rates go down but complex fusion procedures increase 15 foId!! Complications increase by more than 100%!! Who needs this? You know these cases become terribly expensive. The surgery costs alone merit close scrutiny.  And the complications inherent in these procedures virtually guarantee many future procedures and a great supply of pharmaceuticals (which, of course, continue to increase throughout the claimants life).

OMCA specializes in difficult cases. Our utilization review process (accredited by URAC for workers’ compensation medical management), is aggressive, fair and thorough; our physician advisor panel is filled with national experts in a variety of medical specialties. We excel in applying evidence—based medicine to workers compensation cases; we excel in combating prescription drug abuse.

Call us with your difficult, ugly cases.

We can do better.

Posted in Workers’ Compensation