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    Fifth of Medicare Patients With Spinal Stenosis Have Surgery

    Types of surgeries performed vary by timing of treatment

    FRIDAY, July 2 (HealthDay News) -- About one out of five Medicare patients with lumbar spinal stenosis (LSS) receives surgery within three years of diagnosis, and there appears to be an association between the type of surgery provided and the point after diagnosis when surgery is carried out, according to research published in the July issue of The Spine Journal.

    Er Chen, of Quorum Consulting Inc. in San Francisco, and colleagues examined administrative claims data on 6,265 Medicare patients newly diagnosed with LSS to determine the rates and types of surgical treatment, length of time to treatment, and Medicare costs.

    The researchers found that 21 percent of the patients, particularly younger and healthier ones, had surgery within three years of their initial diagnosis, with most of the surgeries (78 percent) occurring in the first year. Laminectomies and laminotomies were the most frequently performed procedures in all years, but a higher percentage of fusions were performed in those whose surgeries occurred in the second or third year. Medicare payments were $49,624 in the surgery group, compared with $36,691 in the non-surgical group. Costs were significantly higher for patients who had fusion or laminectomy/laminotomy plus fusion than for those who had laminectomy or laminotomy.

    "The surgical management of LSS varies with respect to timing and type of surgery provided. Such variation needs to be explained beyond demographic and comorbid factors," the authors write.

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