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Virginia Mason Study Shows Team Method Prevents Overuse of Spinal Fusion Surgery
SEATTLE – (Feb. 20, 2017) – Patients diagnosed with lumbar degenerative spine disease are more likely to receive the right care when a team of experts representing multiple medical specialties collaborate in reviewing the patient’s needs and determining the best treatment option.
This is the finding of a study at the Virginia Mason Spine Clinic, titled “Multidisciplinary Evaluation Leads to the Decreased Utilization of Lumbar Spine Fusion: An Observational Cohort Pilot Study” and published by the journal, Spine, in January.
In this study, a total of 137 patients referred to Virginia Mason over a 10-month period for consideration of spinal fusion were reviewed by a multidisciplinary panel of physiatrists, neurosurgeons, nurses, physician assistants, pain specialists, orthopedic spine surgeons, anesthesiologists and physical therapists. Of those patients, 100 had been recommended for lumbar spine fusion by a surgeon outside Virginia Mason. After reviewing medical charts and other information for each patient, the panel of Virginia Mason experts determined that a non-operative treatment – instead of surgery – was more appropriate for 58 percent of the patients.
“Involving representatives of different medical disciplines in decision-making is essential to ensuring the quality of spine care, decreasing the overutilization of surgery, and improving the patient’s experience,” said Rajiv Sethi, MD, medical director, Virginia Mason Neuroscience Institute, and co-author of the study. The multidisciplinary team approach is a standard process at the Spine Clinic.
Isolated surgical decision-making can result in inappropriate treatment that is a disservice to patients, a waste of health care sources, and an unnecessary cost for the patient and the provider. By comparison, multidisciplinary collaboration that empowers experts from multiple specialties is more likely to result in the appropriate use of surgical and non-operative treatment options.
“We strive to provide our patients the right care at the right time,” Dr. Sethi said. “Accomplishing this requires a team approach – including multidisciplinary conversations that empower all team members – which focuses on each patient’s unique needs. Surgery is not always the best nor most appropriate treatment.”
Lumbar spine fusion, a surgical treatment for acute lower back pain, involves using bone graft to allow two vertebrae to grow together into one solid bone. The number of these procedures has increased more than six-fold in the United States over the past two decades, according to federal statistics. This dramatic increase has fueled questions about whether the procedure is overused when other treatment options could also benefit patients.
The Virginia Mason study has earned acclaim from the Spine Safety Summit and Foundation and the American Association of Neurological Surgeons.
About Virginia Mason Health System
Virginia Mason, founded in 1920, is a nonprofit regional health care system based in Seattle that serves the Pacific Northwest. In the Puget Sound region, the system includes 336-bed Virginia Mason Hospital; a primary and specialty care group practice of more than 470 physicians; regional medical centers in Seattle, Bainbridge Island, Bellevue, Federal Way, Kirkland, Issaquah and Lynnwood; Bailey-Boushay House, the first skilled-nursing and outpatient chronic care management program in the United States designed and built specifically to meet the needs of people with HIV/AIDS; Benaroya Research Institute, which is internationally recognized for autoimmune disease research; and Virginia Mason Institute, which trains health care professionals and others from around the world in the Virginia Mason Production System, an innovative management methodology for continually improving quality, safety and efficiency. Virginia Mason online: VirginiaMason.org
Virginia Mason Health System also includes Virginia Mason Memorial, a 226-bed hospital serving the Yakima Valley in central Washington since 1950. Memorial online: YakimaMemorial.org
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Virginia Mason Health System