Utilization and Economic Impact of Posterolateral Fusion and Posterior/Transforaminal Lumbar Interbody Fusion Surgeries in the United States

Comron Saifi; Alejandro Cazzulino; Joseph Laratta; Akshay Save; Jamal N. Shillingford; Philip K. Louie; Andrew J. Pugely; Vincent Arlet

doi:10.1177/2192568218790557

Back

Utilization and Economic Impact of Posterolateral Fusion and Posterior/Transforaminal Lumbar Interbody Fusion Surgeries in the United States

Journal article

Open access

Peer reviewed

Utilization and Economic Impact of Posterolateral Fusion and Posterior/Transforaminal Lumbar Interbody Fusion Surgeries in the United States

Comron Saifi, Alejandro Cazzulino, Joseph Laratta, Akshay Save, Jamal N. Shillingford, Philip K. Louie, Andrew J. Pugely and Vincent Arlet

Global spine journal, Vol.9(2), pp.185-190

04/01/2019

DOI: 10.1177/2192568218790557

PMCID: PMC6448193

PMID: 30984499

Files and links (1)

url

https://doi.org/10.1177/2192568218790557View

Published (Version of record) Open Access

Abstract

Study Design: Retrospective database study. Objective: To analyze the economic and age data concerning primary and revision posterolateral fusion (PLF) and posterior/transforaminal lumbar interbody fusion (PLIF/TLIF) throughout the United States to improve value-based care and health care utilization. Methods: The National Inpatient Sample (NIS) database was queried by the International Classification of Diseases, Ninth Revision, Clinical Modification codes for patients who underwent primary or revision PLF and PLIF/TLIF between 2011 and 2014. Age and economic data included number of procedures, costs, and revision burden. The National Inpatient Sample database represents a 20% sample of discharges from US hospitals weighted to provide national estimates. Results: From 2011 to 2014, the annual number of PLF and PLIF/TLIF procedures decreased 18% and increased 23%, respectively, in the Unites States. During the same period, the number of revision PLF decreased 19%, while revision PLIF/TLIF remained relatively unchanged. The average cost of PLF was lower than the average cost of PLIF/TLIF. The aggregate national cost for PLF was more than $3 billion, while PLIF/TLIF totaled less than $2 billion. Revision burden (ratio of revision surgeries to the sum of both revision and primary surgeries) remained constant at 8.0% for PLF while it declined from 3.2% to 2.9% for PLIF/TLIF. Conclusion: This study demonstrated a steady increase in PLIF/TLIF, while PLF alone decreased. The increasing number of PLIF/TLIF procedures may account for the apparent decline of PLF procedures. There was a higher average cost for PLIF/TLIF as compared with PLF. Revision burden remained unchanged for PLF but declined for PLIF/TLIF, implying a decreased need for revision procedures following the initial PLIF/TLIF surgery.

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Orthopedics

Science & Technology

Details

Title: Subtitle: Utilization and Economic Impact of Posterolateral Fusion and Posterior/Transforaminal Lumbar Interbody Fusion Surgeries in the United States
Creators: Comron Saifi - Annenberg Public Policy Center
Alejandro Cazzulino - Annenberg Public Policy Center
Joseph Laratta - Columbia University Medical Center
Akshay Save - Columbia University
Jamal N. Shillingford - Columbia University Medical Center
Philip K. Louie - Rush Univ, Med Ctr, Chicago, IL 60612 USA
Andrew J. Pugely - University of Iowa
Vincent Arlet - Annenberg Public Policy Center
Resource Type: Journal article
Publication Details: Global spine journal, Vol.9(2), pp.185-190
DOI: 10.1177/2192568218790557
PMID: 30984499
PMCID: PMC6448193
NLM abbreviation: Global Spine J
ISSN: 2192-5682
eISSN: 2192-5690
Publisher: Sage
Number of pages: 6
Language: English
Date published: 04/01/2019
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984304711402771

Metrics

20 Record Views

33 Times Cited - Web of Science