BOSTON, Feb. 22, 2023 /PRNewswire/ -- In a large, national study, researchers reported unexpected findings that support the benefit of spine surgery for spinal stenosis over conventional medical treatment. The study, published in the Journal of Bone and Joint Surgery was a collaboration between Health Data Analytics Institute (HDAI) and Raymond Hwang MD, MEng, MBA and Scott G. Tromanhauser, MD, MBA, MHCDS at New England Baptist Hospital in Boston. Using big data and predictive analytics, they compared clinically matched patients who received operative or nonoperative treatment of spinal stenosis and found that surgery was associated with lower mortality and cost over two years in some cases.
The Journal of Bone & Joint Surgery Infographic
"Frankly we were surprised ourselves by what we found." said Scott G. Tromanhauser, MD, MBA, MHCDS at New England Baptist Hospital. "This work demonstrates the power of large, national data sets and sophisticated analytic methodologies to provide better understanding of the longer-term impact of the care we provide to our patients. I also expect that similar work will become a fundamental component in the transition to future value-based care programs."
According to Wolters Kluwer Health, patients with spinal stenosis experience narrowing of the spinal canal and compression of spinal nerves, causing back pain, leg pain, and other symptoms. In some patients, stenosis is related to degenerative spondylolisthesis, referring to "slipped" vertebrae often resulting from spinal degeneration. "We are committed to leveraging predictive models and advanced analytics to generate these types of comparative effectiveness insights to help patients, providers, and payers understand their options as they face ever more complex healthcare decisions." says Nassib Chamoun, CEO of HDAI.
The paper is one of the first real-world-evidence studies that links spine surgery to lower mortality and lower costs among Medicare patients with spinal stenosis. For those without spondylolisthesis, costs are lower with laminectomy and higher with fusion. The researchers point out some limitations of the study, including the possible effects of unrecognized confounding factors.
These findings may have important implications for clinical practice, especially considering recent increases in the use and costs of lumbar fusion surgery. Based on the observed mortality and cost reductions, "The current study suggests that this trend may be justified within the Medicare population" for well-selected patients, Dr. Hwang and coauthors conclude.
In the accompanying editorial, Daniel G. Torbert, MD, of Massachusetts General Hospital states that "These results will surely need replication with data that are prospectively collected over longer time frames with more granular clinical variables… On balance, however, the finding of improvement in all-cause mortality and health-care utilization associated with surgical treatment is a step toward a more comprehensive understanding of the optimal treatment for lumbar stenosis."
The study was published in the February issue of The Journal of Bone & Joint Surgery. The full report and an accompanying editorial can be viewed here: JBJS and here: JBJS editorial
About HDAI
HDAI is a care optimization and provider enablement company powered by big data, proprietary predictive analytics, expert insights and point of care technology solutions. We partner with leading health systems, ACOs, MA plans, and payers to improve care delivery, population health and cost. Our integrated capabilities help organizations understand every dimension of performance and provide a direct path to patient specific actionability. For more information, please visit: www.hda-institute.com.
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