An Inside Look at Spinal Discectomy vs. Spinal Fusion Surgery

Back pain is the second most popular reason why people go to their doctor (second to the common flu.) There are many different reasons why people develop back problems and different ways to treat the pain and physical issues that drives people to a doctor, physical therapist, or in extreme cases, a spine surgeon.


If you have been dealing with chronic back pain and mobility issues, and perhaps you've been seeing a physical therapist about it, it may be time to have a conversation about spine surgery to effectively treat your condition for the long-term. There are two common spine surgical procedures that are very effective and have helped many people get over their back pain: spinal fusion and spinal discectomy.

What is Spinal Fusion?

When one or more vertebrae are united or fused together the process is known spinal fusion. People often think of it as welding but it is less about welding but more about grafting one bone to another. The actual “welding” occurs as the body heals the graft over a period of several months.

Reasons for Spinal Fusion Surgery

Spinal fusion surgery is often recommended to treat broken vertebrae, to correct abnormalities like slippages or spinal curves and to eliminate pain from motion. It has also been used to treat some ceria disc hernias as well as certain spinal instability.

Instability refers to excessive motion between vertebrae. This is thought to be the main cause of most back and neck pain and since it can cause damage to nerves, it is a condition that needs to be dealt with sooner than later.

How is Spinal Fusion Surgery Performed?

There are many approaches or methods that a surgeon can take to conduct a fusion surgery but they all have one thing in common, a bone graft. Whether for cervical or lumbar spinal fusion surgery, the bone graft is placed either on the front of the vertebrae or the back or by doing it both ways. The surgeon is the one who needs to determine the correct approach that will make the final outcome positive and speed up the actual fusion time.

Most board-certified spine specialists perform a frontal bone graft because it is easy but fusing the lumbar and thoracic segments of the spine is best approached from a posterior side. Sometimes the surgery requires the use of screws, cages or splints to hold the vertebrae together as the bones fuse. The desired outcome of a spinal fusion surgery is a solid union or vertebrae

Spinal Discectomy

Spinal discectomy is a common surgical procedure done to treat conditions like herniated or ruptured discs or lumbar spine. Disc herniation or disc prolapse occurs when the outer wall of a disc, the annulus fibrosus is weakened. The weakening may cause the inner soft part of the disc to tear causing the nucleus pulposus to push its way out.

When this material extends past the margin of the outer disc and can cause excruciating pain as it presses against sensitive nerve in the spine. The nerve tissue might get damage causing the patient to feel weak or feel tingling or a pricking sensation in the legs and arms.

Reasons for Spinal Discectomy

Spinal discectomy is a procedure that is meant to take the pressure off the sensitive nerve tissue by removing part of the damaged disc. Not everybody with a herniated disc needs to undergo surgery. Some people find relief from non-surgical treatment and anti-inflammatory medication.

How is Spinal Discectomy Surgery Performed?

Spinal discectomy is an open surgery that involves having a small incision over the spine. Some ligament and bone material might be removed to gain access to the damaged disc. Spinal surgery has been undergoing some exciting changes and there are now more novel and less invasive ways to perform spinal surgery.

Effective Strategies to Optimize Surgery Billing Processes

Private healthcare providers know that if they don't get enough cash flowing into the revenue stream, they cannot continue to provide proper care and keep their practices afloat. As much as we’d wish health care to be less about money but more about people getting the help they need, many private healthcare practices need to optimize every avenue to succeed, especially surgeons.

In most cases, clinical and surgery billing information is kept separate, making it hard to integrate the various departments that patients go through. One departments’ inefficiency can affect the integrity of the revenue cycle. Surgeons and related healthcare providers can lose between 3 and 5 percent on their revenue if there are no tight controls.

While there are many services, techniques, and software available to help with surgery billing and revenue cycle management, there are three primary areas that healthcare providers can address and optimize for better financial health.

1. Patient Access

A large portion of a patient’s claim form is generated at the first consultation. This is where as much information that a patient can give is collected, it is also a point where the healthcare provider gets to contact the medical insurance company.

 It is important to have a good software program and a seamless link to the network of insurance companies to obtain approvals for certain procedures and avoid denials of payment later on when the patient has received the treatment and care. It is also important for healthcare providers to have clear guidelines about collecting and validating patient information.

2. Insurance Validation

Issues experienced with insurance verification or pre-authorization in the admission process are caused by failure to wait the prescribed 12 to 24 hour waiting process that is commonly required to get healthcare insurance company claims verified especially in cases of emergency.

It becomes important for facilities to require some kind of up-front cash payment, which payments can claim back from their insurer if the procedure ends up being approved. Patients need to be made aware that they might have to pay upfront upon admission and they would need to be appraised of what they are being billed for if they stay for an extended period in the hospital.

It might sound tedious but it helps the patient and the healthcare provider to keep tabs on the costs of treatment. It always helps to know what insurers normally pay for and what they don’t. There are systems and programs that can be used to automatically notify both the healthcare provider, the healthcare insurer and the patient.

3. Charge Capture

For surgeons and healthcare providers to improve the charge processes they need to test the completeness and accuracy of the charging process. Caregivers can use a method to identify lost charges and finding where the revenue leakage is. There are IT tools that can help identify missed charges effectively and more efficiently. With such tools, surgeons can avoid complications with surgery billing.

4. Surgery Billing & Payment Accuracy

The processes involved in billing, collections and payment management are the key processes for revenue optimization. To maintain a healthy bottom line it is important to identify payment inaccuracies this involves improvements in technological processes that makes timely resolution of billing issues.

The correct tracking methods can help in the monitoring, classification and resolution of payment issues. Surgeons and medical staff who have the tools to identify, understand and quantify the root causes of bad debts are an a better position to avoid and actually see the opportunities that exist more effectively.

As much as we’d like to escape the truth, the fact is healthcare is a business and it is important for healthcare providers to keep their revenue collection strategies in tact. The industry has been known to be unstable when coming to keeping their revenue integrity.