Study suggests surgical treatment for herniated discs increases savings to society over long term

Annually, more than 10 million people experience back pain in the United States. More than 200,000 of these patients undergo surgery to alleviate pain due to a herniated disc. Surgery to remove the disc has been found to be an effective way to improve these patients' quality of life in cases where conservative treatment is ineffective, but until now, little was known about the societal benefits of surgery and workplace productivity in particular. A new study uncovered that the estimated average annual earnings of working patients who undergo surgery are $47,619, compared to $45,694 for those with non-surgical treatments. Therefore, the annual earnings are increased by $1,925 for those patients receiving surgery. Additionally, patients who undergo surgery miss three fewer days of work each year as compared to patients who elect for nonsurgical treatment.

The new study, published in the April issue of The Journal of Clinical Orthopaedics and Related Research (CORR) suggests surgical treatment for herniated discs increases average annual earnings and reduces the number of work days employees miss due to back pain. The authors of "Cost-effectiveness of Lumbar Discectomy," found these surgeries are cost-effective and may result in savings to society when patients' back pain is alleviated over the long term. The study found that over a four-year period, surgery resulted in cost offsets of more than $5,000 due to higher earnings for patients receiving surgery.

For example, terrible back pain following an injury on the field limited lacrosse coach Scott Hiller from coaching, and even made it difficult to perform everyday tasks such as walking around the house and holding his children. After trying non-operative treatments, Scott underwent disc herniation repair surgery and now is able to live a life without pain due to a herniated disc.

"Back pain is one of the most common and the most difficult orthopaedic conditions for patients, since both standing and sitting may exacerbate the pain. As a result, whether you work in physical labor or sitting at a desk, back pain can affect your ability to work," said Michael Schafer, MD, professor of orthopaedic surgery, Northwestern University and an author of the study. "Pain from a herniated disc causes the average employee to miss 26 days of work each year and spend 34 days in bed. Surgery, when appropriate, can lessen the pain, increase productivity and reduce number of missed workdays. This study strengthened the body of research that indicates surgery to repair herniated discs can be effective and cost-effective for patients."

To conduct the study, researchers reviewed literature and used patient reported outcomes from prior studies. The collected data were applied to a Markov Decision Model where they estimated direct and indirect costs associated with surgical and continued non-operative treatment for a herniated disc by comparing costs for household income and missed workdays and disability payments.

The American Academy of Orthopaedic Surgeons (AAOS) commissioned KNG Health Consulting, LLC (KNG Health) and its partner, IHS Global Inc., to prepare this study.