The spine as a profit centre?
A recent evaluation by the German health insurer Techniker Krankenkasse of a special second opinion program before back operations shows that 88 percent of back operations are unnecessary. These results confirm the findings of earlier studies...
The spine as a profit center?
Zweitmeinung Rücken-OPs | Die Techniker - Presse & Politik (tk.de)
Hamburg, 29 April 2024: A recent evaluation by Techniker Krankenkasse on a special second opinion program before back surgery shows that 88 percent of back operations are unnecessary. These results confirm the findings of previous studies, including those by Dhillon et al. (2016), Bogduk and Anderson (2009) and Machado et al. (2016). They have already established that no clear pathophysiological diagnosis can be made in 80 to 95% of patients who undergo surgery. The benefit of spinal surgery is therefore low, or at least no better than conservative treatment.
This naturally raises questions:
- Nevertheless, from 2007 to 2015, back operations climbed from 452,000 to 772,000, an increase of 71 percent!
- There are serious regional differences - in some regions, operations are performed up to 13 times more frequently than elsewhere (Berthelsmann Foundation). There is no medical explanation for this.
- What is the clinical significance of radiological diagnoses such as herniated discs, stenosis, nerve entrapment resulting in neuropathic pain?
- How can it be explained that the symptoms of a dysfunctional large joint largely correspond to the symptoms of a radicular syndrome?
- How can it be explained that the symptoms of a dysfunctional large joint largely correspond to the symptoms of radicular syndrome?
- Is the theoretical framework used to explain back pain still correct? Are there alternatives? If so, which ones?
- There is a consensus on the positive effects of physical activity on back pain and general health - but it is still a challenge for many people living with chronic pain. TK has shown that this approach is effective with its IVR program which patients are motivated to be physically active under intensive and comprehensive care. If the focus of agnosis and treatment is extended to the function of the large joints, the effectiveness of exercise/training programs could be increased even further. Why is this not being utilized much earlier and much more extensively?
- Obviously there is a tension between ethics and economic interest - the spine as a profit centre?