Formal Radiologist Interpretations of Intraoperative Spine Radiographs Have Low Clinical Value.

Area of Science:

• Orthopedic Surgery
• Radiology
• Health Economics

Background:

• Spine surgery faces scrutiny for rising healthcare costs, emphasizing value-based care.
• Intraoperative radiographic analysis presents a potential source of unnecessary healthcare expenses.

Purpose of the Study:

• To evaluate the clinical relevance, usefulness, and financial implications of radiologist interpretation of intraoperative spine radiographs.

Main Methods:

• Retrospective cohort analysis of adult elective spine surgeries (July 2020-July 2021).
• Collected demographic, radiographic (localization and post-instrumentation), and financial data.
• Assessed report timeliness, clinical relevance, and clinical usefulness.

Main Results:

• Median delay of 128 minutes between imaging and report completion.
• Only 38.9% of reports were completed before surgery conclusion.
• 79.4% were clinically relevant, but only 33.5% were clinically useful.
• Interpretation fees incurred a minimum total cost of $15,392.

Conclusions:

• Formal interpretation of intraoperative spine radiographs has low clinical utility for surgeons.
• Institutions should optimize radiology workflows for timeliness and relevance.
• Consider evaluating the necessity of routine radiologist consultation for intraoperative spine imaging to maximize value-based care.