Single Position Lumbar Spine Interbody Fusion and Pedicle Screw Placement Reduces Operating Room Costs

Area of Science:

• Spine surgery
• Orthopedics
• Minimally invasive procedures

Background:

• Spine surgeons are increasingly adopting single-position (SP) techniques for lumbar interbody fusions to decrease operative times and costs.
• The actual extent of cost savings associated with SP approaches in the U.S. remains under-investigated.

Purpose of the Study:

• To compare the quality metrics and cost-effectiveness of single-position (SP) versus dual positioning (DP) approaches for lumbar interbody fusion (LLIF) or anterior lumbar interbody fusion (ALIF) combined with posterior pedicle screw fixation.
• To evaluate the impact of surgical positioning on operative variables, complications, and overall costs.

Main Methods:

• A retrospective cohort study design was employed, comparing patients who underwent SP versus DP approaches for LLIF or ALIF at a single institution.
• Data collected included cost metrics, patient demographics, complication rates, operative variables, and surgical details.
• Univariate and multivariate analyses were performed to identify predictors of increased costs.

Main Results:

• The SP group exhibited significantly decreased mean operative time (221 min vs. 367 min) and length of stay (3.3 days vs. 4.4 days) compared to the DP group.
• Operating room costs, variable costs, and total costs were significantly lower in the SP cohort ($38,379 vs. $48,378).
• Complication rates were comparable between the SP and DP groups.

Conclusions:

• Single-position (SP) surgery significantly reduces operative time, length of stay, and overall costs compared to traditional dual positioning (DP) surgery for lumbar interbody fusions.
• SP surgery presents a cost-effective approach with a comparable safety profile to DP surgery.
• While surgeon preference and other factors may influence cost variations, SP approaches are supported as a financially advantageous option.