Cost and Utilization Trends of Lumbar Fusion
Brook I. Martin, Sohail K. Mirza, Brian A. Karamian, Andrew J. Schoenfeld, Hyunkyu Ko, Pradeep Suri, Darrel S. Brodke

TL;DR
Lumbar fusion surgery in the US increased in use and cost from 2002 to 2023, with more complex procedures and outpatient settings becoming common.
Contribution
The study provides updated national trends on lumbar fusion utilization, costs, and procedural complexity over 21 years.
Findings
Adjusted inpatient hospital costs for lumbar fusion increased by 265.3% from 2002 to 2023.
Multilevel and anterior-posterior column fusions became more common over time.
Outpatient lumbar fusion procedures increased from 2.1% in 2016 to 9.8% in 2022.
Abstract
What changes in lumbar fusion surgery utilization and costs occurred between 2002 and 2023? In this cross-sectional study of more than 5 million lumbar fusion admissions, adjusted inpatient hospital and mean inpatient per-procedure costs increased. There were increased trends toward fusions involving 2 or more disc levels and in anterior-posterior column fusion in more recent years as well as a trend toward procedures in outpatient facilities. In this study, lumbar fusion trends were marked by greater utilization of multilevel and anterior-posterior approaches and greater use in the outpatient setting. This cross-sectional study evaluates whether approaches to lumbar fusion surgery, utilization of the procedure, and costs have changed between 2002 and 2023 in the United States. The increasing cost of lumbar fusion has invited payment reforms, such as mandatory price limits by…
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Taxonomy
TopicsSpine and Intervertebral Disc Pathology · Health Systems, Economic Evaluations, Quality of Life · Spinal Fractures and Fixation Techniques
