Single-level lumbar spinal fusion costs are determined by a variety of factors, but surgeon decisions play a significant role, according to a study in the September 2024 issue of The Spine Journal.
Six notes:
1. Researchers looked at data for patients who had single-level lumbar spinal fusion Nov. 2, 2021, and Dec. 2, 2022, at two hospitals within the same health system. Total hospital cost of care; preoperative, intraoperative, and postoperative cost of care, and the ratio of most to least expensive 1-level lumbar fusion were measured.
2. The most expensive single-level lumbar spinal fusion was 6.8 times more expensive than the least expensive one, the study said. The intraoperative period accounted for 88% of the total cost in the most expensive lumbar fusion.
3. Implant costs accounted for 30% of the total fees, on average. However across all patients, implant costs accounted for anywhere between 6% to 44% of the total fees.
4. Lumbar spinal fusion cases that were more expensive tended to have younger patients and patients who were more likely to have commercial health insurance. Increased age was associated with decreased costs, and some surgeons are associated with decreased total costs, after accounting for other factors.
5. Researchers found a poor correlation between time of surgery and total overall costs.
6. "A large variation exists in the total hospital cost for patients undergoing 1-level lumbar fusion, which is primarily driven by surgeon-level decisions and preferences (e.g., implant and technology use)," the study concluded, . [B]eing a 'fast' surgeon intraoperatively does not mean your total cost is meaningfully lower. As efforts continue to optimize patient value through ensuring appropriate clinical outcomes while also reducing cost, spine surgeons must use this knowledge to lead, or at least be active participants in, any discussions that could impact patient care."