Back pain is a prevalent issue in America, and adults over the age of 65 are more likely to experience it. Surgery can seem like a simple fix, but it’s more likely a waste of money and risky, according to recent research from the Lown Institute, a health care think tank.
Lown researchers found that U.S. hospitals performed more than 200,000 unnecessary back surgeries on Medicare beneficiaries over a three-year period — wasting more than $1.9 billion in Medicare funds.
The report examined the following procedures performed on Medicare patients between 2021 and 2023 at over 2,400 hospitals:
- Spinal fusion
- Laminectomy
- Vertebroplasty
Spinal fusion and laminectomy involve either fusing vertebrae together or removing part of a vertebra to treat back pain. Vertebroplasty involves injecting medical cement into fractured vertebrae.
Low-value procedures
The Lown Institute identified these procedures as low-value based on medical evidence. For patients with low back pain caused by aging, these surgeries offer little to no benefit compared to nonsurgical alternatives or even placebo procedures.
Nonetheless, they occurred at a high rate — about one every eight minutes — and more than 90% of hospitals with the capacity to perform these procedures overused them on Medicare patients.
There are risks to these surgeries too. Complications from spinal fusion occur in up to 18% of patients and can include infection, blood clots, stroke, pneumonia and even death. Vertebroplasty complications occur in 5% to 10% of patients.
“Like everyone in America, older people with back pain deserve safe, evidence-based care that doesn’t waste taxpayer dollars. Reducing unnecessary procedures, particularly invasive ones that carry grave risks, is a moral imperative,” said Dr. Vikas Saini, president of the Lown Institute.
The states with the highest volumes of unnecessary spinal fusions were California, Florida, Texas and Pennsylvania, with at least 5,000 unnecessary procedures done in each state.
For vertebroplasty, Texas, Florida and Ohio led with at least 6,000 unnecessary procedures each.
However, the rates varied dramatically from one hospital to another, even among facilities in the same geographic area.
For example, Massachusetts General Hospital performed vertebroplasty five times more frequently than nearby Brigham and Women’s Hospital for patients with the same diagnosis. That suggests that the problem may be systemic in how hospitals and physicians approach these procedures.
Hospitals with the lowest and highest rates for unnecessary surgeries
Following are the hospitals with the lowest overuse rates for spinal fusion:
- Avala in Louisiana — 0.1% overuse rate
- Northwest Specialty Hospital in Idaho — 0.9%
- Baylor Surgical Hospital at Las Colinas in Texas — 1.2%
- Fresno Surgical Hospital in California — 1.4%
- Christus Mother Frances Hospital – Tyler in Texas — 1.5%
- McBride Orthopedic Hospital in Oklahoma — 1.5%
Here are the hospitals with the highest overuse rates for spinal fusion:
- Mount Nittany Medical Center in Pennsylvania — 57.2% overuse rate
- Concord Hospital in New Hampshire — 39.5%
- Lutheran Hospital of Indiana — 38.6%
- Heritage Valley Sewickley in Pennsylvania — 37.7%
- HCA HealthONE Aurora in Colorado — 37.6%
For vertebroplasty, several hospitals performed zero unnecessary procedures despite having opportunities to do so, including MetroHealth Medical Center in Ohio and Harborview Medical Center in Washington.
Meanwhile, the hospitals with the highest vertebroplasty overuse rates were:
- Kettering Health Miamisburg in Ohio — 56.1% overuse rate
- Shannon Medical Center in Texas — 54.6%
- St. Elizabeth Florence Hospital in Kentucky — 50.1%
- AdventHealth Shawnee Mission in Kansas — 47.9%
- CHI St. Vincent Infirmary in Arkansas — 46.7%
CMS plans to take action
The Lown Institute’s findings highlight a widespread problem in American health care, where financial incentives and practice patterns can lead to procedures that don’t benefit patients and may actually harm them.
The Center for Medicare and Medicaid Services has noticed the troubling trend and is planning to take action. Vertebroplasty and cervical fusion surgery are among the procedures that a new Medicare pilot program starting in 2026 aims to reduce.
For more on finding the best hospitals, check out “The 20 Highest-Ranked Hospitals in America in 2026.”
And if you suffer from back pain, learn how you can find relief without medical intervention in “5 Science-Backed Ways to Ease Back Pain Naturally.”
Sources
CDC; Lown Institute article; Lown Institute report; CMS; Fierce Healthcare
Add a Comment