Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015

Martin, Brook I.; Mirza, Sohail K.; Spina, Nicholas; Spiker, W. Ryan; Lawrence, Brandon D.; Brodke, Darrel S.

doi:10.1097/brs.0000000000002822

Cited by 568 publications

(447 citation statements)

References 37 publications

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“…There are several reasons why this may be the case, including increased demand for spinal procedures and greater profits to be made in patenting implants and other spinal devices. One study found that there has been a 62% increase in procedure volume for lumbar fusions from 2004 to 2015, with many more elective spinal fusions for degenerative conditions [27]. Furthermore, the microeconomy for spinal implants causes great variability in implant costs.…”

Section: Discussionmentioning

confidence: 99%

Patents and Innovation Among Neurosurgeons from the American Association of Neurological Surgeons

Baron

Kessler

Bhammar

et al. 2020

Cureus

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Section: Discussionmentioning

confidence: 99%

Patents and Innovation Among Neurosurgeons from the American Association of Neurological Surgeons

Baron

Kessler

Bhammar

et al. 2020

Cureus

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“…4,5 However, as the frequency of spine surgeries continue to increase, it is important to understand the role of pharmacological pain management in the restoration of normal function to these patients. 6 This is especially true in light of the current opioid epidemic as policy makers act to throttle prescriptions while patient perceptions of pain control have become incorporated into satisfaction scores used as a surrogate measure of hospital quality. 7 Strategies for postoperative pain management have evolved over time.…”

Section: Introductionmentioning

confidence: 99%

Predictive Risk Factors Associated With Increased Opioid Use Among Patients Undergoing Elective Spine Surgery

et al. 2020

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Background: Opioids are commonly used for postoperative pain management in spine surgery. However, few guidelines exist for appropriate prescribing in the acute postoperative phase of care. We identify risk factors for inpatient (IP) opioid use and examine relationships between IP requirements and discharge (DC) opioid prescriptions.Methods: Retrospective review of elective spine surgeries between January 2014 and May 2018 identified cases of lumbar decompression (LD), LD with fusion (LDF), and cervical decompression with fusion (CDF) at our high-volume spine center. Multiple regression examining potential risk factors for opioid use was performed. Opioid use was normalized into daily morphine milligram equivalents (MME).Results: A total of 2281 patients who underwent 1251 LD, 384 LDF, and 648 CDF procedures were identified (54.1% male, mean age ¼ 57.9 years, mean body mass index ¼ 30.3 kg/m 2 , median American Society of Anesthesiologists [ASA] score ¼ 2). Mean IP opioid use was 44.4 MME/day and average DC prescriptions totaled 496.5 MME. Multiple regression models identified younger age and increased ASA score as predictive of increased daily IP opioid consumption (b AGE ¼À0.36, P , .001, b ASA ¼ 10.1, P , .001; R 2 ¼ 0.308) and increased DC opioid amounts (b AGE ¼À4.62, P , .001, b ASA ¼ 72.1, P , .001; R 2 ¼ 0.097). Highest IP and DC opioid use was observed among LDF followed by CDF and LD patients. Significant positive correlations were found between IP opioid usage and DC opioid prescriptions by IP opioid quartiles (r ¼ 0.99 LD, 0.98 LDF, 0.96 CDF).Conclusions: Younger patients and higher ASA scores correlated with increased IP opioid use and DC opioid prescriptions. DC prescriptions appropriately reflect IP use.Level of Evidence: 3. Clinical Relevance: Adequate pain management is an integral component to successful outcomes in spine surgery. Awareness of candidates likely to require higher levels of opioid analgesia will be beneficial in guiding surgeon prescribing practices. Complications

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“…Owing to innovations in surgical techniques and devices, the frequencies of spinal surgery procedures have been increasing steadily during the past decades. Between the years 2004 and 2015, the number of elective spinal surgeries performed to achieve lumbar fusion reportedly increased from 122 679 to 199 140 (1). This amounted to a 177% increase in total hospital costs, with more than $10 billion in hospital costs in 2015 (1).…”

Section: Introductionmentioning

confidence: 99%

“…Between the years 2004 and 2015, the number of elective spinal surgeries performed to achieve lumbar fusion reportedly increased from 122 679 to 199 140 (1). This amounted to a 177% increase in total hospital costs, with more than $10 billion in hospital costs in 2015 (1). Similarly, the total number of cervical spine surgeries performed reportedly increased from 27 061 to 34 582 between the years 2001 and 2013, with a 64% increase in costs (2).…”

Section: Introductionmentioning

confidence: 99%

Postoperative Spinal CT: What the Radiologist Needs to Know

Ghodasara

Clark

et al. 2019

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During the past 2 decades, the number of spinal surgeries performed annually has been steadily increasing, and these procedures are being accompanied by a growing number of postoperative imaging studies to interpret. CT is accurate for identifying the location and integrity of implants, assessing the success of decompression and intervertebral arthrodesis procedures, and detecting and characterizing related complications. Although postoperative spinal CT is often limited owing to artifacts caused by metallic implants, parameter optimization and advanced metal artifact reduction techniques, including iterative reconstruction and monoenergetic extrapolation methods, can be used to reduce metal artifact severity and improve image quality substantially. Commonly used and recently available spinal implants and prostheses include screws and wires, static and extendable rods, bone grafts and biologic materials, interbody cages, and intervertebral disk prostheses. CT assessment and the spectrum of complications that can occur after spinal surgery and intervertebral arthroplasty include those related to the position and integrity of implants and prostheses, adjacent segment degeneration, collections, fistulas, pseudomeningoceles, cerebrospinal fluid leaks, and surgical site infections. Knowledge of the numerous spinal surgery techniques and devices aids in differentiating expected postoperative findings from complications. The various types of spinal surgery instrumentation and commonly used spinal implants are reviewed. The authors also describe and illustrate normal postoperative spine findings, signs of successful surgery, and the broad spectrum of postoperative complications that can aid radiologists in generating reports that address issues that the surgeon needs to know for optimal patient management.©RSNA, 2019.

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Trends in Lumbar Fusion Procedure Rates and Associated Hospital Costs for Degenerative Spinal Diseases in the United States, 2004 to 2015

Abstract: 3.

Cited by 568 publications

References 37 publications

Patents and Innovation Among Neurosurgeons from the American Association of Neurological Surgeons

Patents and Innovation Among Neurosurgeons from the American Association of Neurological Surgeons

Predictive Risk Factors Associated With Increased Opioid Use Among Patients Undergoing Elective Spine Surgery

Postoperative Spinal CT: What the Radiologist Needs to Know

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