FRIDAY, June 11 (HealthDay News) -- Patients with lumbar disc herniation incur substantial charges for preoperative care in the months before discectomy -- during a period of conservative management -- which are roughly equally divided between diagnostic charges and therapeutic charges, according to research published in the June issue of The Spine Journal.
Scott D. Daffner, M.D., of West Virginia University in Morgantown, and colleagues analyzed data from 30,709 patients in a commercially available database of patients with orthopedic diagnoses. All of the patients underwent lumbar discectomy, and the researchers assessed charge codes for the 90 days before the surgery, during a period of nonoperative conservative management.
The researchers found that a total of $105,799,925 was charged during this period, averaging $3,445 per patient. The average discectomy charge was $7,841. Total charges for injection procedures were $16,211,246 (32 percent of total charges); diagnostic imaging was $15,648,769 (31 percent); outpatient visits were $6,552,135 (13 percent); physical therapy visits were $5,723,644 (11 percent); chiropractic manipulation was $1,177,406 (2 percent); and medications were $263,039 (0.5 percent).
"In conclusion, our data demonstrate significant charges associated with failed nonoperative treatment of intervertebral disc herniations. Given that a large number of patients may improve with conservative measures, a trial of nonoperative care is appropriate," the authors write. "To better understand ways to contain costs, future studies should focus on predicting which patients will fail nonoperative management and would likely benefit from proceeding directly to surgical treatment."
A co-author disclosed financial relationships with a number of medical device companies.
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