Chemonucleolysis versus surgical discectomy. Comparison of costs and results in workers' compensation claimants

A retrospective review of insurance claim files was conducted to compare the costs of chemonucleolysis with surgical discectomy. Twenty-nine surgeons performed 61 chemonucleolysis procedures and 44 surgical discectomies on SAIF (State Accident Insurance Fund, Inc.--a major Oregon workers' compensation insurance company) claimants between December 1982 and April 1984. Clinical data and treatment costs were tabulated during February 1985. In this population of 105 workers' compensation claimants, the average cost/claim of the workers treated by chemonucleolysis was higher than the average cost/claim of workers treated initially by surgical discectomy. The average cost/claim was somewhat lower in successful chemonucleolysis cass than in successful surgical discectomy cases, but the average cost/claim of unsuccessful chemonucleolysis cases was much higher than unsuccessful surgical discectomy cases. In order for chemonucleolysis to be a cost effective method compared to initial surgical discectomy, it would be necessary to attain a much higher chemonucleolysis success rate than observed in this group of patients.