(Reuters)
Updated: 2008-02-13 13:02

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The proportion of spine patients reporting physical, social and work limitations rose to 24.7 percent in 2005 from 20.7 percent in 1997.

"What we're seeing is that although costs have gone up, outcomes have not changed, which is really discouraging," said Dr. Orly Avitzur, a neurologist from Tarrytown, New York, and an adviser to Consumer Reports, which recently named back surgery on its top 10 list of "Medical Gotchas."

The research follows a number of recent studies showing that some patients who skip surgery for back pain fare just as well over time as those who have the surgery.

"It's best to be conservative and take a wait-and-see approach, especially in the initial stages of low back pain," Avitzur said in a telephone interview.

Dr. Paul Rubery, a spine surgeon at the University of Rochester Medical Center in New York, noted that higher drug spending and increased use of diagnostic tests such as magnetic resonance imaging accounted for a lot of the increased costs.

He said the study emphasizes the need for use of treatments with proven benefits.

Dr. Richard Fessler, a professor of neurosurgery at Northwestern University in Chicago, challenged the study's findings and methodology. "I think their conclusions are unwarranted and very misleading," he said.

Fessler, in an e-mail, said the study fails to mention several large recent clinical trials that showed certain patients undergoing spinal surgery improved significantly.

Martin said his work is not an indictment of any one approach to treating back pain. "This study is a broad view of trends overall," he said.

"Really, the goal should be to match the right treatment to the right patient who will benefit from it. I think that is sometimes where we fall short."

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