[Artificial Disc Replacement] Another ADR/Fusion Cost Comparison Study

[Researcher]

Journal of Spinal Disorders and Techniques 2008;21:473–476

Lumbar Spinal Fusion Versus Anterior Lumbar Disc Replacement The Financial Implications

Vikas V. Patel, MA, MD, Susan Estes, NP, Emily M. Lindley, PhD, and Evalina Burger, MD

Study Design: Cost-identification analysis with retrospective and calculated cost.

Objective: To determine the relative cost of lumbar spinal fusion versus anterior lumbar disc replacement.

Summary of Background Data: Although several methods of treatment for lumbar spinal degenerative disc disease are currently accepted, no single treatment has been proven superior. In the past, the standard treatment has been spinal fusion; however, fusion surgery has many short and long-term limitations. Lumbar disc replacement surgery is now Food and Drug Administration-approved and is an accepted treatment in well selected patients. Initial results showed its equivalence with fusion in 2-year outcome studies, and more recent data has even indicated a superiority. In the current healthcare system, cost of the treatment plays a major role in the availability and acceptance of medical therapies. To date, cost analysis information has not been available for disc replacement surgery relative to spinal fusion.

Methods: A review of hospital costs was performed for 10 randomly selected patients in each group who underwent singlelevel lumbar transforaminal interbody fusion (TLIF), anterior and posterior spinal fusion (ASF/PSF), ASF alone, and anterior disc replacement. Additionally, the University Hospital Consortium database was queried for average cost per hospital day and average cost per operating room minute. These data were combined with ProDisc clinical IDE trial data to calculate the cost of each treatment.

Results: The actual cost of implants at our institution for ASF/ PSF, ASF, TLIF, and disc replacement were similar when rhBMP-2 was not included in the calculations. Total hospital costs for ASF/PSF were significantly higher than for TLIF, ASF, or disc replacement.

Conclusions: The hospital cost of disc replacement surgery is similar to TLIF and ASF (when rhBMP-2 cost is excluded) and is significantly less expensive than ASF/PSF.

Copyright 2008 by Lippincott Williams & Wilkins

******
I have a full copy if anyone can't locate it on the internet. The analysis is very good and the numbers can be helpful to someone including financial comparisons in an appeal. The same goes for the previous cost analysis I posted today.

I corresponded directly with the author of this study and got some clarification on what is included in the cost figures if anyone has questions.

Phil

[Justin]

For completeness, here is a link to a previous discussion on this publication.

Lumbar Spinal Fusion Versus Anterior Lumbar Disc Replacement: The Financial Implications

[Jack-of-all-trades]

My minimally invasive posterior lumbar fusion of L5-S1 last December totaled $88,000.00, give or take a thousand. It included post-op visits within 90 days of the surgery. The titanium rods and bolts were $26,000.00. I requested and received an itemized bill. What got my goat was that I found approx. $600.00 in mistakes in the hospitals favor. They refunded it to the insurance company without a penny coming to me after I did all the work. Not so much as a thank you from my insurance company.