Trends in spinal implant utilization and pricing

Area of Science:

• Orthopedic Surgery
• Spine Surgery Trends
• Medical Device Utilization

Background:

• Spine surgery volume in the U.S. has escalated, driven by advancements in physiology and technology.
• Implant development has influenced shifts in spinal implant usage over recent decades.

Purpose of the Study:

• To analyze trends in spinal implant utilization in the U.S. from 2013 to 2022.
• To identify changes in the types and materials of spinal implants used.

Main Methods:

• Utilized data from Orthopedic Network News on spine implant utilization and pricing (2013-2022).
• Analyzed 664,310 spine procedure purchase orders, adjusting prices for inflation.
• Employed linear regression to analyze trends in implant usage and cost.

Main Results:

• Spine procedure volume increased from ~800,000 (2013) to over 1.1 million (2022), primarily lumbar/cervical fusions.
• Proportion of procedures in patients >64 years old significantly increased (50% lumbar, 37% cervical).
• Lumbar pedicle screw (PS) prices decreased, while metal interbody device usage significantly increased, replacing PEEK and allograft.

Conclusions:

• Nationwide spine procedure volume rose significantly, dominated by lumbar and cervical fusions.
• Pedicle screw constructs with interbody fusion devices remain the most common lumbar fusion treatment.
• Metal interbody devices have become the preferred material, supplanting PEEK and allograft.