Skip to main content
Top
Published in: Current Reviews in Musculoskeletal Medicine 3/2019

01-09-2019 | Minimally Invasive Surgery | Minimally Invasive Spine Surgery (W Hsu, Section Editor)

Economic Value in Minimally Invasive Spine Surgery

Authors: Benjamin Hopkins, Aditya Mazmudar, Kartik Kesavabhotla, Alpesh A Patel

Published in: Current Reviews in Musculoskeletal Medicine | Issue 3/2019

Login to get access

Abstract

Purpose of Review

The field of spine surgery remains a unique target in the transition to value-based care. While spine surgery has benefited from new medical technologies, including minimally invasive surgery (MIS), these technologies may be a key driver in rising US healthcare costs. As such, MIS needs to clear an economic value threshold through a rigorous evaluation of the outcomes they provide and costs they incur. In this article, we review recent MIS surgery literature from the perspective of economic value.

Recent Findings

Many studies report modest all-in cost savings and direct procedural cost equivalence for minimally invasive approaches relative to open surgeries. In terms of quality, studies found lower blood loss, length of stay, and infectious complications with MIS surgery but evidence on QALYs was mixed.

Summary

In the past 5 years, there has been increasing research interest in defining economic value in MIS surgery. However, a significant amount of heterogeneity in research quality and methodology persists. Therefore, MIS surgery has the potential to be of high economic value, though this is not yet definitive. Future research should continue to focus on high-quality cost-effectiveness studies with clear methodologies to further elucidate economic value in MIS surgery.
Literature
1.
go back to reference McCarthy M. US healthcare spending is expected to accelerate after recent lull. BMJ. 2014;349:g5514.CrossRef McCarthy M. US healthcare spending is expected to accelerate after recent lull. BMJ. 2014;349:g5514.CrossRef
2.
go back to reference Kazberouk A, McGuire K, Landon BE. A survey of innovative reimbursement models in spine care. Spine (Phila Pa 1976). 2016;41(4):344–52.CrossRef Kazberouk A, McGuire K, Landon BE. A survey of innovative reimbursement models in spine care. Spine (Phila Pa 1976). 2016;41(4):344–52.CrossRef
3.
go back to reference Rossi VJ, Ahn J, Bohl DD, Tabaraee E, Singh K. Economic factors in the future delivery of spinal healthcare. World J Orthop. 2015;6(5):409–12.CrossRef Rossi VJ, Ahn J, Bohl DD, Tabaraee E, Singh K. Economic factors in the future delivery of spinal healthcare. World J Orthop. 2015;6(5):409–12.CrossRef
4.
go back to reference Parker SL, Chotai S, Devin CJ, Tetreault L, Mroz TE, Brodke DS, et al. Bending the cost curve-establishing value in spine surgery. Neurosurgery. 2017;80(3S):S61–9.CrossRef Parker SL, Chotai S, Devin CJ, Tetreault L, Mroz TE, Brodke DS, et al. Bending the cost curve-establishing value in spine surgery. Neurosurgery. 2017;80(3S):S61–9.CrossRef
5.
go back to reference Birkmeyer JD, Gust C, Baser O, Dimick JB, Sutherland JM, Skinner JS. Medicare payments for common inpatient procedures: implications for episode-based payment bundling. Health Serv Res. 2010;45(6 Pt 1):1783–95.CrossRef Birkmeyer JD, Gust C, Baser O, Dimick JB, Sutherland JM, Skinner JS. Medicare payments for common inpatient procedures: implications for episode-based payment bundling. Health Serv Res. 2010;45(6 Pt 1):1783–95.CrossRef
6.
go back to reference Scalise J, Jacofsky D. Payor reform opportunities for spine surgery: part I: background and stimulus for bundled payments. Clin Spine Surg. 2017;30(5):229–31.CrossRef Scalise J, Jacofsky D. Payor reform opportunities for spine surgery: part I: background and stimulus for bundled payments. Clin Spine Surg. 2017;30(5):229–31.CrossRef
7.
8.
go back to reference A. G. Burden of muskuloskeletal diseases spine: low back and neck pain. 2014. A. G. Burden of muskuloskeletal diseases spine: low back and neck pain. 2014.
9.
go back to reference Fehlings MG, Tetreault L, Nater A, Choma T, Harrop J, Mroz T, et al. The aging of the global population: the changing epidemiology of disease and spinal disorders. Neurosurgery. 2015;77(Suppl 4):S1–5.CrossRef Fehlings MG, Tetreault L, Nater A, Choma T, Harrop J, Mroz T, et al. The aging of the global population: the changing epidemiology of disease and spinal disorders. Neurosurgery. 2015;77(Suppl 4):S1–5.CrossRef
10.
go back to reference Oppenheimer JH, DeCastro I, McDonnell DE. Minimally invasive spine technology and minimally invasive spine surgery: a historical review. Neurosurg Focus. 2009;27(3):E9.CrossRef Oppenheimer JH, DeCastro I, McDonnell DE. Minimally invasive spine technology and minimally invasive spine surgery: a historical review. Neurosurg Focus. 2009;27(3):E9.CrossRef
11.
go back to reference Deyo RA, Mirza SK. Trends and variations in the use of spine surgery. Clin Orthop Relat Res. 2006;443:139–46.CrossRef Deyo RA, Mirza SK. Trends and variations in the use of spine surgery. Clin Orthop Relat Res. 2006;443:139–46.CrossRef
12.
go back to reference Callahan D. “Healthcare costs and medical technology” The Hastings Center and the early years of bioethics. Kennedy Inst Ethics J 1999;9(1):53–71. Callahan D. “Healthcare costs and medical technology” The Hastings Center and the early years of bioethics. Kennedy Inst Ethics J 1999;9(1):53–71.
13.
go back to reference Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477–81.CrossRef Porter ME. What is value in health care? N Engl J Med. 2010;363(26):2477–81.CrossRef
14.
go back to reference Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009;361(2):109–12.CrossRef Porter ME. A strategy for health care reform--toward a value-based system. N Engl J Med. 2009;361(2):109–12.CrossRef
15.
go back to reference Allen RT, Garfin SR. The economics of minimally invasive spine surgery: the value perspective. Spine (Phila Pa 1976). 2010;35(26 Suppl):S375–82.CrossRef Allen RT, Garfin SR. The economics of minimally invasive spine surgery: the value perspective. Spine (Phila Pa 1976). 2010;35(26 Suppl):S375–82.CrossRef
16.
go back to reference Awad BI, Lubelski D, Shin JH, Carmody MA, Hoh DJ, Mroz TE, et al. Bilateral pedicle screw fixation versus unilateral pedicle and contralateral facet screws for minimally invasive transforaminal lumbar interbody fusion: clinical outcomes and cost analysis. Global Spine J. 2013;3(4):225–30.CrossRef Awad BI, Lubelski D, Shin JH, Carmody MA, Hoh DJ, Mroz TE, et al. Bilateral pedicle screw fixation versus unilateral pedicle and contralateral facet screws for minimally invasive transforaminal lumbar interbody fusion: clinical outcomes and cost analysis. Global Spine J. 2013;3(4):225–30.CrossRef
17.
go back to reference Neumann PJ, Cohen JT, Weinstein MC. Updating cost-effectiveness--the curious resilience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371(9):796–7.CrossRef Neumann PJ, Cohen JT, Weinstein MC. Updating cost-effectiveness--the curious resilience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371(9):796–7.CrossRef
18.
go back to reference Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the panel on cost-effectiveness in health and medicine. JAMA. 1996;276(15):1253–8.CrossRef Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the panel on cost-effectiveness in health and medicine. JAMA. 1996;276(15):1253–8.CrossRef
19.
go back to reference Fidai MS, Saltzman BM, Meta F, Lizzio VA, Stephens JP, Bozic KJ, et al. Patient-reported outcomes measurement information system and legacy patient-reported outcome measures in the field of orthopaedics: a systematic review. Arthroscopy. 2018;34(2):605–14.CrossRef Fidai MS, Saltzman BM, Meta F, Lizzio VA, Stephens JP, Bozic KJ, et al. Patient-reported outcomes measurement information system and legacy patient-reported outcome measures in the field of orthopaedics: a systematic review. Arthroscopy. 2018;34(2):605–14.CrossRef
20.
go back to reference McDonald KM, Romano PS, Geppert J, et al. In: Measures of patient safety based on hospital administrative data - the patient safety indicators. Rockville (MD)2002. McDonald KM, Romano PS, Geppert J, et al. In: Measures of patient safety based on hospital administrative data - the patient safety indicators. Rockville (MD)2002.
21.
go back to reference Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine. 2018;28(3):268–79.CrossRef Boody BS, Bhatt S, Mazmudar AS, Hsu WK, Rothrock NE, Patel AA. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery. J Neurosurg Spine. 2018;28(3):268–79.CrossRef
22.
go back to reference Bhatt S, Boody BS, Savage JW, Hsu WK, Rothrock NE, Patel AA. Validation of patient-reported outcomes measurement information system computer adaptive tests in lumbar disk herniation surgery. J Am Acad Orthop Surg. 2018:1. Bhatt S, Boody BS, Savage JW, Hsu WK, Rothrock NE, Patel AA. Validation of patient-reported outcomes measurement information system computer adaptive tests in lumbar disk herniation surgery. J Am Acad Orthop Surg. 2018:1.
23.
go back to reference Purvis TE, Neuman BJ, Riley LH 3rd, Skolasky RL. Can early patient-reported outcomes be used to identify patients at risk for poor 1-year health outcomes after lumbar laminectomy with arthrodesis? Spine (Phila Pa 1976). 2018;43(15):1067–73. Purvis TE, Neuman BJ, Riley LH 3rd, Skolasky RL. Can early patient-reported outcomes be used to identify patients at risk for poor 1-year health outcomes after lumbar laminectomy with arthrodesis? Spine (Phila Pa 1976). 2018;43(15):1067–73.
24.
go back to reference Hartman JD, Craig BM. Comparing and transforming PROMIS utility values to the EQ-5D. Qual Life Res. 2018;27(3):725–33.CrossRef Hartman JD, Craig BM. Comparing and transforming PROMIS utility values to the EQ-5D. Qual Life Res. 2018;27(3):725–33.CrossRef
25.
go back to reference Vijan S. Should we abandon QALYs as a resource allocation tool? Pharmacoeconomics. 2006;24(10):953–4.CrossRef Vijan S. Should we abandon QALYs as a resource allocation tool? Pharmacoeconomics. 2006;24(10):953–4.CrossRef
26.
go back to reference • Tapp SJ, Martin BI, Tosteson TD, et al. Understanding the value of minimally invasive procedures for the treatment of lumbar spinal stenosis: the case of interspinous spacer devices. Spine J. 2018;18(4):584–92. This study finds that interspinous spacers may be cost-effective as an initial treatment option for lumbar spinal stenosis. The cost-effectiveness may improve over time as more of these procedures are being done in outpatient surgery centers with lower cost structures.CrossRef • Tapp SJ, Martin BI, Tosteson TD, et al. Understanding the value of minimally invasive procedures for the treatment of lumbar spinal stenosis: the case of interspinous spacer devices. Spine J. 2018;18(4):584–92. This study finds that interspinous spacers may be cost-effective as an initial treatment option for lumbar spinal stenosis. The cost-effectiveness may improve over time as more of these procedures are being done in outpatient surgery centers with lower cost structures.CrossRef
27.
go back to reference Al-Khouja LT, Baron EM, Johnson JP, Kim TT, Drazin D. Cost-effectiveness analysis in minimally invasive spine surgery. Neurosurg Focus. 2014;36(6):E4.CrossRef Al-Khouja LT, Baron EM, Johnson JP, Kim TT, Drazin D. Cost-effectiveness analysis in minimally invasive spine surgery. Neurosurg Focus. 2014;36(6):E4.CrossRef
28.
go back to reference Fehlings MG, Nater A, Chapman J, Harrop J, Mroz T. Consensus statement: systematic reviews of value-based surgical spine care: what do we know? Where are the limitations? Spine (Phila Pa 1976). 2014;39(22 Suppl 1):S3–6.CrossRef Fehlings MG, Nater A, Chapman J, Harrop J, Mroz T. Consensus statement: systematic reviews of value-based surgical spine care: what do we know? Where are the limitations? Spine (Phila Pa 1976). 2014;39(22 Suppl 1):S3–6.CrossRef
29.
go back to reference Johans SJ, Amin BY, Mummaneni PV. Minimally invasive lumbar decompression for lumbar stenosis: review of clinical outcomes and cost effectiveness. J Neurosurg Sci. 2015;59(1):37–45.PubMed Johans SJ, Amin BY, Mummaneni PV. Minimally invasive lumbar decompression for lumbar stenosis: review of clinical outcomes and cost effectiveness. J Neurosurg Sci. 2015;59(1):37–45.PubMed
30.
go back to reference Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, et al. Is minimal access spine surgery more cost-effective than conventional spine surgery? Spine (Phila Pa 1976). 2014;39(22 Suppl 1):S65–74.CrossRef Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, et al. Is minimal access spine surgery more cost-effective than conventional spine surgery? Spine (Phila Pa 1976). 2014;39(22 Suppl 1):S65–74.CrossRef
31.
go back to reference •• Pendharkar AV, Shahin MN, Ho AL, et al. Outpatient spine surgery: defining the outcomes, value, and barriers to implementation. Neurosurg Focus. 2018;44(5):E11. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthroplasty can all be performed as outpatient spine surgies. This study summarizes the proposed cost savings and potential barriers in the transition to outpatient spine surgery.CrossRef •• Pendharkar AV, Shahin MN, Ho AL, et al. Outpatient spine surgery: defining the outcomes, value, and barriers to implementation. Neurosurg Focus. 2018;44(5):E11. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthroplasty can all be performed as outpatient spine surgies. This study summarizes the proposed cost savings and potential barriers in the transition to outpatient spine surgery.CrossRef
32.
go back to reference Newton PO, Upasani VV, Lhamby J, Ugrinow VL, Pawelek JB, Bastrom TP. Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. Surgical technique. J Bone Joint Surg Am. 2009;91(Suppl 2):233–48.CrossRef Newton PO, Upasani VV, Lhamby J, Ugrinow VL, Pawelek JB, Bastrom TP. Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. Surgical technique. J Bone Joint Surg Am. 2009;91(Suppl 2):233–48.CrossRef
33.
go back to reference Parker SL, Adogwa O, Bydon A, Cheng J, McGirt MJ. Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years. World Neurosurg. 2012;78(1–2):178–84.CrossRef Parker SL, Adogwa O, Bydon A, Cheng J, McGirt MJ. Cost-effectiveness of minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis associated low-back and leg pain over two years. World Neurosurg. 2012;78(1–2):178–84.CrossRef
34.
go back to reference Parker SL, Anderson LH, Nelson T, Patel VV. Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: conservative care, laminectomy, and the superion interspinous spacer. Int J Spine Surg. 2015;9:28.CrossRef Parker SL, Anderson LH, Nelson T, Patel VV. Cost-effectiveness of three treatment strategies for lumbar spinal stenosis: conservative care, laminectomy, and the superion interspinous spacer. Int J Spine Surg. 2015;9:28.CrossRef
35.
go back to reference Pelton MA, Phillips FM, Singh K. A comparison of perioperative costs and outcomes in patients with and without workers’ compensation claims treated with minimally invasive or open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976). 2012;37(22):1914–9.CrossRef Pelton MA, Phillips FM, Singh K. A comparison of perioperative costs and outcomes in patients with and without workers’ compensation claims treated with minimally invasive or open transforaminal lumbar interbody fusion. Spine (Phila Pa 1976). 2012;37(22):1914–9.CrossRef
36••.
go back to reference Phan K, Hogan JA, Mobbs RJ. Cost-utility of minimally invasive versus open transforaminal lumbar interbody fusion: systematic review and economic evaluation. Eur Spine J. 2015;24(11):2503–13. In this systematic review, outcomes and costs of minimally invasive open transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar pathologies are explored. Results suggest significantly reduced perioperative costs, length of stay, and blood loss for minimally invasive compared with open TLIF.CrossRef Phan K, Hogan JA, Mobbs RJ. Cost-utility of minimally invasive versus open transforaminal lumbar interbody fusion: systematic review and economic evaluation. Eur Spine J. 2015;24(11):2503–13. In this systematic review, outcomes and costs of minimally invasive open transforaminal lumbar interbody fusion (TLIF) for degenerative lumbar pathologies are explored. Results suggest significantly reduced perioperative costs, length of stay, and blood loss for minimally invasive compared with open TLIF.CrossRef
37.
go back to reference Singh K, Nandyala SV, Marquez-Lara A, Fineberg SJ, Oglesby M, Pelton MA, et al. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion. Spine J. 2014;14(8):1694–701.CrossRef Singh K, Nandyala SV, Marquez-Lara A, Fineberg SJ, Oglesby M, Pelton MA, et al. A perioperative cost analysis comparing single-level minimally invasive and open transforaminal lumbar interbody fusion. Spine J. 2014;14(8):1694–701.CrossRef
38.
go back to reference Lucio JC, Vanconia RB, Deluzio KJ, Lehmen JA, Rodgers JA, Rodgers W. Economics of less invasive spinal surgery: an analysis of hospital cost differences between open and minimally invasive instrumented spinal fusion procedures during the perioperative period. Risk Manag Healthc Policy. 2012;5:65–74.PubMedPubMedCentral Lucio JC, Vanconia RB, Deluzio KJ, Lehmen JA, Rodgers JA, Rodgers W. Economics of less invasive spinal surgery: an analysis of hospital cost differences between open and minimally invasive instrumented spinal fusion procedures during the perioperative period. Risk Manag Healthc Policy. 2012;5:65–74.PubMedPubMedCentral
39.
go back to reference Parker SL, Mendenhall SK, Shau DN, Zuckerman SL, Godil SS, Cheng JS, et al. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis. World Neurosurg. 2014;82(1–2):230–8.CrossRef Parker SL, Mendenhall SK, Shau DN, Zuckerman SL, Godil SS, Cheng JS, et al. Minimally invasive versus open transforaminal lumbar interbody fusion for degenerative spondylolisthesis: comparative effectiveness and cost-utility analysis. World Neurosurg. 2014;82(1–2):230–8.CrossRef
40.
go back to reference Udeh BL, Costandi S, Dalton JE, Ghosh R, Yousef H, Mekhail N. The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients. Pain Pract. 2015;15(2):107–16.CrossRef Udeh BL, Costandi S, Dalton JE, Ghosh R, Yousef H, Mekhail N. The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients. Pain Pract. 2015;15(2):107–16.CrossRef
41.
go back to reference Vertuani S, Nilsson J, Borgman B, Buseghin G, Leonard C, Assietti R, et al. A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom. Value Health. 2015;18(6):810–6.CrossRef Vertuani S, Nilsson J, Borgman B, Buseghin G, Leonard C, Assietti R, et al. A cost-effectiveness analysis of minimally invasive versus open surgery techniques for lumbar spinal fusion in Italy and the United Kingdom. Value Health. 2015;18(6):810–6.CrossRef
42.
go back to reference Wang MY, Lerner J, Lesko J, McGirt MJ. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 2012;25(6):324–8.CrossRef Wang MY, Lerner J, Lesko J, McGirt MJ. Acute hospital costs after minimally invasive versus open lumbar interbody fusion: data from a US national database with 6106 patients. J Spinal Disord Tech. 2012;25(6):324–8.CrossRef
43.
go back to reference • Gandhoke GS, Shin HM, Chang YF, Tempel Z, Gerszten PC, Okonkwo DO, et al. A cost-effectiveness comparison between open transforaminal and minimally invasive lateral lumbar interbody fusions using the incremental cost-effectiveness ratio at 2-year follow-up. Neurosurgery. 2016;78(4):585–95. This study showed that TLIF and LLIF produced equivalent 2-year patient outcomes at an equivalent cost-effectiveness profile. Mean total cost of care and EuroQol-5D were statistically equivalent between the 2 treatment groups.CrossRef • Gandhoke GS, Shin HM, Chang YF, Tempel Z, Gerszten PC, Okonkwo DO, et al. A cost-effectiveness comparison between open transforaminal and minimally invasive lateral lumbar interbody fusions using the incremental cost-effectiveness ratio at 2-year follow-up. Neurosurgery. 2016;78(4):585–95. This study showed that TLIF and LLIF produced equivalent 2-year patient outcomes at an equivalent cost-effectiveness profile. Mean total cost of care and EuroQol-5D were statistically equivalent between the 2 treatment groups.CrossRef
44.
go back to reference Parker SL, Adogwa O, Witham TF, Aaronson OS, Cheng J, McGirt MJ. Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg. 2011;54(1):33–7.CrossRef Parker SL, Adogwa O, Witham TF, Aaronson OS, Cheng J, McGirt MJ. Post-operative infection after minimally invasive versus open transforaminal lumbar interbody fusion (TLIF): literature review and cost analysis. Minim Invasive Neurosurg. 2011;54(1):33–7.CrossRef
45.
go back to reference • Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques. Spine J. 2018; This study evaluated the cost-effectiveness of the less invasive transpsoas interbody fusion technique for patients with adult degenerative scoliosis over a 12-month time period. Transpsoas surgeries were associated with better HRQol outcomes and lower costs at 1-year follow-up relative to the open technique. • Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques. Spine J. 2018; This study evaluated the cost-effectiveness of the less invasive transpsoas interbody fusion technique for patients with adult degenerative scoliosis over a 12-month time period. Transpsoas surgeries were associated with better HRQol outcomes and lower costs at 1-year follow-up relative to the open technique.
46.
go back to reference Uddin OM, Haque R, Sugrue PA, Ahmed YM, el Ahmadieh TY, Press JM, et al. Cost minimization in treatment of adult degenerative scoliosis. J Neurosurg Spine. 2015;23(6):798–806.CrossRef Uddin OM, Haque R, Sugrue PA, Ahmed YM, el Ahmadieh TY, Press JM, et al. Cost minimization in treatment of adult degenerative scoliosis. J Neurosurg Spine. 2015;23(6):798–806.CrossRef
47.
go back to reference Mansfield HE, Canar WJ, Gerard CS, O’Toole JE. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus. 2014;37(5):E9.CrossRef Mansfield HE, Canar WJ, Gerard CS, O’Toole JE. Single-level anterior cervical discectomy and fusion versus minimally invasive posterior cervical foraminotomy for patients with cervical radiculopathy: a cost analysis. Neurosurg Focus. 2014;37(5):E9.CrossRef
48.
go back to reference Ackerman SJ, Polly DW Jr, Knight T, Holt T, Cummings J. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population. Clinicoecon Outcomes Res. 2014;6:63–74.CrossRef Ackerman SJ, Polly DW Jr, Knight T, Holt T, Cummings J. Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population. Clinicoecon Outcomes Res. 2014;6:63–74.CrossRef
49.
go back to reference Ackerman SJ, Polly DW Jr, Knight T, Holt T, Cummings J Jr. Nonoperative care to manage sacroiliac joint disruption and degenerative sacroiliitis: high costs and medical resource utilization in the United States Medicare population. J Neurosurg Spine. 2014;20(4):354–63.CrossRef Ackerman SJ, Polly DW Jr, Knight T, Holt T, Cummings J Jr. Nonoperative care to manage sacroiliac joint disruption and degenerative sacroiliitis: high costs and medical resource utilization in the United States Medicare population. J Neurosurg Spine. 2014;20(4):354–63.CrossRef
50.
go back to reference Ackerman SJ, Polly DW Jr, Knight T, Schneider K, Holt T, Cummings J Jr. Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology. Clinicoecon Outcomes Res. 2014;6:283–96.CrossRef Ackerman SJ, Polly DW Jr, Knight T, Schneider K, Holt T, Cummings J Jr. Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology. Clinicoecon Outcomes Res. 2014;6:283–96.CrossRef
51.
go back to reference Lorio M, Martinson M, Ferrara L. Paired comparison survey analyses utilizing Rasch methodology of the relative difficulty and estimated work relative value units of CPT((R)) code 27279. Int J Spine Surg. 2016;10:40.CrossRef Lorio M, Martinson M, Ferrara L. Paired comparison survey analyses utilizing Rasch methodology of the relative difficulty and estimated work relative value units of CPT((R)) code 27279. Int J Spine Surg. 2016;10:40.CrossRef
52.
go back to reference Lonne G, Johnsen LG, Aas E, et al. Comparing cost-effectiveness of X-Stop with minimally invasive decompression in lumbar spinal stenosis: a randomized controlled trial. Spine (Phila Pa 1976). 2015;40(8):514–20.CrossRef Lonne G, Johnsen LG, Aas E, et al. Comparing cost-effectiveness of X-Stop with minimally invasive decompression in lumbar spinal stenosis: a randomized controlled trial. Spine (Phila Pa 1976). 2015;40(8):514–20.CrossRef
53.
go back to reference Menger RP, Savardekar AR, Farokhi F, Sin A. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine. 2018;15(3):216–24.CrossRef Menger RP, Savardekar AR, Farokhi F, Sin A. A cost-effectiveness analysis of the integration of robotic spine technology in spine surgery. Neurospine. 2018;15(3):216–24.CrossRef
54.
go back to reference • Maillard N, Buffenoir-Billet K, Hamel O, Lefranc B, Sellal O, Surer N, Bord E, Grimandi G, Clouet J A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method. Int J Surg 2015;15:68–73. This French study demonstrated that percutaneous osteosynthesis is associated with decreased hospital charges, shorter length of stay, similar clinical outcomes, and equivalent medical device costs compared with open surgery. • Maillard N, Buffenoir-Billet K, Hamel O, Lefranc B, Sellal O, Surer N, Bord E, Grimandi G, Clouet J A cost-minimization analysis in minimally invasive spine surgery using a national cost scale method. Int J Surg 2015;15:68–73. This French study demonstrated that percutaneous osteosynthesis is associated with decreased hospital charges, shorter length of stay, similar clinical outcomes, and equivalent medical device costs compared with open surgery.
55.
go back to reference Slotman GJ, Stein SC. Laparoscopic L5-S1 diskectomy: a cost-effective, minimally invasive general surgery--neurosurgery team alternative to laminectomy. Am Surg. 1996;62(1):64–8.PubMed Slotman GJ, Stein SC. Laparoscopic L5-S1 diskectomy: a cost-effective, minimally invasive general surgery--neurosurgery team alternative to laminectomy. Am Surg. 1996;62(1):64–8.PubMed
56.
go back to reference Fan SW, Fang XQ, Zhao X, Zhao FD. Clinical value of minimally invasive posterior lumbar interbody fusion assisted by X-Tube system in the treatment of low back disorders. Zhonghua Wai Ke Za Zhi. 2008;46(7):488–92.PubMed Fan SW, Fang XQ, Zhao X, Zhao FD. Clinical value of minimally invasive posterior lumbar interbody fusion assisted by X-Tube system in the treatment of low back disorders. Zhonghua Wai Ke Za Zhi. 2008;46(7):488–92.PubMed
57.
go back to reference Newton PO, Wenger DR, Mubarak SJ, Meyer RS. Anterior release and fusion in pediatric spinal deformity. A comparison of early outcome and cost of thoracoscopic and open thoracotomy approaches. Spine (Phila Pa 1976). 1997;22(12):1398–406.CrossRef Newton PO, Wenger DR, Mubarak SJ, Meyer RS. Anterior release and fusion in pediatric spinal deformity. A comparison of early outcome and cost of thoracoscopic and open thoracotomy approaches. Spine (Phila Pa 1976). 1997;22(12):1398–406.CrossRef
58.
go back to reference Parker SL, Adogwa O, Davis BJ, Fulchiero E, Aaronson O, Cheng J, et al. Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis. J Spinal Disord Tech. 2013;26(1):42–7.CrossRef Parker SL, Adogwa O, Davis BJ, Fulchiero E, Aaronson O, Cheng J, et al. Cost-utility analysis of minimally invasive versus open multilevel hemilaminectomy for lumbar stenosis. J Spinal Disord Tech. 2013;26(1):42–7.CrossRef
59.
go back to reference Parker SL, Lerner J, McGirt MJ. Effect of minimally invasive technique on return to work and narcotic use following transforaminal lumbar inter-body fusion: a review. Prof Case Manag. 2012;17(5):229–35.CrossRef Parker SL, Lerner J, McGirt MJ. Effect of minimally invasive technique on return to work and narcotic use following transforaminal lumbar inter-body fusion: a review. Prof Case Manag. 2012;17(5):229–35.CrossRef
60.
go back to reference Cher DJ, Frasco MA, Arnold RJ, Polly DW. Cost-effectiveness of minimally invasive sacroiliac joint fusion. Clinicoecon Outcomes Res. 2016;8:1–14.PubMed Cher DJ, Frasco MA, Arnold RJ, Polly DW. Cost-effectiveness of minimally invasive sacroiliac joint fusion. Clinicoecon Outcomes Res. 2016;8:1–14.PubMed
Metadata
Title
Economic Value in Minimally Invasive Spine Surgery
Authors
Benjamin Hopkins
Aditya Mazmudar
Kartik Kesavabhotla
Alpesh A Patel
Publication date
01-09-2019
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 3/2019
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-019-09560-8

Other articles of this Issue 3/2019

Current Reviews in Musculoskeletal Medicine 3/2019 Go to the issue

Minimally Invasive Spine Surgery (W Hsu, Section Editor)

The Current State of Minimally Invasive Approaches to Adult Spinal Deformity

Distal Radius and Wrist Fractures (E Shin, Section Editor)

Emerging Technologies in Distal Radius Fracture Fixation

Distal Radius and Wrist Fractures (E Shin, Section Editor)

Management of High Energy Distal Radius Injuries

Concussion (C Senter and M Kapadia, Section Editors)

Current Concepts in the Evaluation of the Pediatric Patient with Concussion

Femoroacetabular Impingement/Labral Tears (A Zhang, Section Editor)

Etiology and Pathomechanics of Femoroacetabular Impingement