Hospital cost differences between open and endoscopic lumbar spine decompression surgery

Area of Science:

• Spine surgery
• Minimally invasive surgery
• Health economics

Background:

• Fully endoscopic decompression surgery is gaining popularity for degenerative spine disease.
• While offering some benefits, the cost of advanced endoscopic technologies is debated.
• This study compares costs between open and endoscopic decompression procedures.

Purpose of the Study:

• To evaluate cost differences and identify cost drivers between open and endoscopic decompression surgery.
• To compare in-hospital costs and associated factors for both surgical approaches.

Main Methods:

• Retrospective analysis of lumbar decompression surgeries (open vs. endoscopic) from 2016-2022.
• Inclusion of preoperative comorbidities, surgical characteristics, and postoperative outcomes.
• In-hospital costs, including readmissions, were analyzed and compared.

Main Results:

• Endoscopic surgery (195 cases) was associated with higher total in-hospital costs (115.1% of open procedures).
• Higher disposable supply costs were a major driver for endoscopic procedures (31.7% vs. 10.1%).
• Open surgery had longer hospital stays and more perioperative complications.

Conclusions:

• Endoscopic decompression surgery incurs greater total in-hospital costs than open procedures.
• Disposable supply costs significantly contribute to the higher expense of endoscopic surgery.
• Comprehensive cost evaluations, including patient-reported and social costs, are crucial for clinical decisions.