Spine care: evaluation of the efficacy and cost of emerging technology

Over the last decade a number of new technologies have been introduced to the area of spine care. Although this recent explosion of innovation has brought advances to patient care, it has also brought concerns regarding overuse, increasing costs, and safety. A value-based approach to assessing and purchasing new technology depends on a shift toward comparative effectiveness analysis, transparency in pricing and potential conflicts of interest, and an alignment of incentives and goals among purchasers, consumers, and payers. How to assess the effectiveness of new technology in patient care is an unresolved issue for any cost-effectiveness analysis, as models traditionally used to assess medical therapies (ie, quality-adjusted life years) may not be directly applicable to analysis of surgical intervention. Spine surgeons must be involved in multidisciplinary collaborative efforts to develop models of efficacy analysis and to direct outcomes-based research to appropriately evaluate the benefits of surgical interventions and new technologies.