From cost-effectiveness of procedures to disc replacement outcomes, researchers published multiple findings about spine surgery in 2024.
15 key studies:
1. Bundled payments from private insurers were a viable option for lumbar spinal fusion patients, according to a study published in the January 2024 issue of Spine. The study looked at lumbar spinal fusion patients from October 2018 to December 2018 who used CMS' Bundled Payments for Care Improvement Advance model, and compared that data with private bundle data from 2018 to 2020 to analyze the transition away from BPCI-A.
2. Endoscopic spine surgery costs more for hospitals than open surgical procedures but is associated with fewer complications for patients, according to a study published in the January edition of the Journal of Neurosurgery: Spine. Researchers examined data from 633 open and 195 endoscopic decompression lumbar surgical procedures that were performed from 2016 to 2022. Endoscopic procedures were more costly for hospitals, with disposable supplies accounting for 31.7% of the total cost of cases, compared to 10.1% of the cost for open procedures.
3. Cervical disc replacement has increased significantly from 2011 and 2021 while anterior cervical discectomy and fusion plateaued, according to a study published Feb. 24 in The Spine Journal.
4. Outpatient spine procedures grew among Medicare patients between 2010 and 2021, with significant yearly growth at ASCs, according to a study in the March 2024 issue of the North American Spine Society Journal. Researchers conducted a cross-sectional study of Medicare billing database information for spine procedures between 2010 to 2021 to measure changes in outpatient volume in the Medicare population. The total number of outpatient spine procedures rose about 193% from 2010 to 2021.
5. Although the cost of cervical disc replacement and anterior cervical discectomy and fusion surgery costs are similar, long-term costs are different, according to a study in the April issue of Spine. Researchers used a commercial insurance claims database to analyze data from patients who had one- or two-level ACDF and cervical disc replacements between Jan. 1, 2017, and Dec. 31, 2017. Prices for the surgeries were similar with ACDF mean costs of $26,819, and disc replacement mean costs of $25,954. However postoperative care — which includes physical therapy, pain medication, injections, psychological treatment and additional spine surgeries — cost less for disc replacements after 30 days, 90 days and two years.
6. Over 20 years, only 1.26% of lumbar disc replacements have needed a follow-up revision surgery or removal, spine surgeons at Texas Back Institute in Plano found. Their research, published in the May 15 issue of Spine, looked at data from 2,141 lumbar disc replacements since 2000. Of the total patients, disc removal was done in 24 patients, and 12 patients needed revisions. About 40% of removals and revisions happened in the first 25 total disc replacement cases done by individual surgeons. There was also a patient who had a "significant vascular complication" that was removed after trauma.
7. Weight loss and diabetes medication semaglutide has been linked to a significantly greater risk for repeat operations in patients with diabetes who require lumbar surgery. The risk of an additional procedure was higher among patients who took semaglutide over long periods of time. While spine and orthopedic surgeons have considered the effect of semaglutides on patient care, this is the first study providing evidence of spine surgery effects. The report is based on a study led by researchers at the University of Illinois Chicago.
8. Minimally invasive sacroiliac joint fusion is associated with increased opioid usage, according to a study published in the June 15 edition of Spine. Researchers used an insurance claims database to evaluate 4,666 patients who had minimally invasive SI joint fusion. They found patients tended to fill opioid prescriptions one year postoperatively at a higher rate than those who had other common spine procedures. Chronic users filled the highest opiate dosages in the 30-days after surgery.
9. Bone marrow aspirate injections didn't lead to significant changes for patients who had arthroscopic partial meniscectomy. Of the 95 patients in the study, 83 were included for the final analysis. There weren't significant differences between the groups' patient characteristics, intraoperative variables, concomitant procedures, preoperative PROM scores or preoperative radiographic findings.
11. Less than 2% of cervical disc replacements needed a removal or revision. Researchers with Plano-based Texas Back Institute analyzed data from 1,626 of their cervical disc replacement patients between 2003 to June 2021. Disc replacements of up to three levels and hybrid fusion cases were included.
12. New spine devices had a reduced recall risk compared to orthopedic devices in general, and some tech didn't have any increase in risk, according to a study in the Nov. 1 issue of Spine. Researchers examined data for spine devices that were FDA-cleared between Jan. 1, 2008, and Dec. 31, 2018. They also analyzed interbody fusion and vertebral body replacement devices as a recall risk factor. A total of 2,384 spine devices were cleared by the FDA through the study period, the study found. The risk of recall after five years was 5.3% and 6.5% after a decade.
13. Radiologists were able to reach "nearly perfect" diagnoses for lumbar spine MRIs if they get patent-reported symptom information, according to an Oct. 29 study in Radiology. The single-center study involved 240 participants who did pre-MRI symptom questionnaires between May 2022 and February 2023. Agreements on pain generators were "almost perfect" for interpretations with the self-reported questionnaire compared to specialists' diagnoses.
14. Laminoplasty and laminectomy and fusion are both options to address cervical myelopathy, but their cost-effectiveness varies, according to a study in the Nov. 15 issue of Spine. Researchers did a retrospective analysis of 277 cervical laminoplasties and 229 cervical laminectomies with fusion. They analyzed facility costs, including personnel and supply. Other analyses including and excluding implant costs were also performed. Cervical laminectomy with fusion patients had increased total facility costs including and excluding implant costs.
15. Augmented reality and robot-assisted spine surgery both yielded high precision in pedicle screw placement, a study out of New York City-based Hospital for Special Surgery found.The study included 212 adult spine surgery patients who had a total 1,211 pedicle screws placed with either robotics or augmented reality, according to a Dec. 6 news release. They had surgery between June 2020 and October 2023.Researchers evaluated the position of each screw and used the Gertzbein-Robbins classification system, which assigns a grade of A, B, C or D, to label accuracy. There wasn't any significant difference in accuracy between robotic navigation and AR screw placement.