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More and more operations for back pain - strong regional differences
In recent years there has been frequent criticism that too much and too quick surgery is carried out in German clinics. The criticism has apparently changed little. New figures show that there are more and more surgical interventions due to back pain in Germany. However, there are enormous regional differences.
Conservative therapies for back problems are usually sufficient
Back pain is one of the most common health complaints in Germany. Those affected are usually advised not to take excessive care of their symptoms, but rather to strengthen their backs with exercise. But although conservative therapies for back pain are often sufficient according to experts and surgery is rarely useful, more and more patients with such complaints are coming to the hospital in Germany.
More and more back operations
Surgery for low back pain has increased significantly. This is shown by a study carried out on behalf of the Bertelsmann Foundation.
According to this, the back surgery increased from 2007 to 2015 by 71 percent from 452,000 to 772,000.
It is striking that "certain back operations are performed differently depending on where the patient lives," the foundation wrote in a statement.
According to the information, there are large differences depending on the region whether the doctors operate or choose another treatment method.
Extreme regional differences
"In some regions, operations are up to 13 times more frequent than elsewhere," is the headline of the Bertelsmann Stiftung.
Serious regional differences can therefore be seen in complex stiffening operations (spondylodesis). For example, patients in the Fulda district have 13 times as many procedures as in Frankfurt / Oder.
In addition, many districts in Thuringia, Hesse and Saarland have strikingly high numbers of operations per 100,000 inhabitants. In most Saxon districts and in Bremen, such operations are much less common.
Differences of up to 13 times were also found for the removal of bony structures on the spinal canal (decompression surgery), and up to 6 times for intervertebral disc operations.
"These big differences cannot be explained medically," says the message.
The situation in "operating strongholds" has worsened in recent years. "There is an urgent need for more transparency about local health care in order to avoid oversupply or undersupply," said Brigitte Mohn, Board Member of the Bertelsmann Stiftung.
Many measures can be done on an outpatient basis
The Bertelsmann Foundation's Health Facts Check also found that the number of patients admitted to hospital for back pain increased from 116,000 in 2007 to 200,000 in 2015.
This corresponds to an increase of 73 percent. The large and increasing differences between the circles are also noticeable here.
Many hospital stays are avoidable, since the majority of these patients in the hospital did not receive any specific pain therapy or surgical interventions, but mostly only diagnostic services, such as an MRI. Such measures could mostly also be carried out on an outpatient basis.
Individual preferences of the doctors
"Operating or not - that also depends on the habits of the doctors," write the experts.
It is difficult to explain why the supply in the regions is so different with the available data. Many factors played together and varied depending on the region.
Large regional deviations are an indication that the organization of care and the procedure for diagnosis and therapy of back complaints are very different.
"Local care patterns increase when there are no clear medical guidelines," said Eckhard Volbracht, health expert at the Bertelsmann Stiftung.
"However, the decision for an operation should not be based on the individual preferences of the local doctors."
In principle, patients are advised to seek a second medical opinion before surgery. (Ad)