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Spine-Related Health Care Utilization and Costs Following Orthobiologic Injection Versus Lumbar Surgery for
Trevor A Lentz1,2,3, Joshua Burrows4, Amanda Brucker4
1Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA.
Medrxiv : the Preprint Server for Health Sciences
|April 10, 2026
Summary
Platelet-rich plasma (PRP) treatment for degenerative spine conditions is associated with lower healthcare costs and utilization compared to surgery. This study found no increased risk of subsequent surgery for patients receiving PRP, supporting its consideration as a less invasive option.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Health Economics
Background:
- Lumbar fusion and decompression surgeries are common for degenerative spine conditions but incur high costs and variable outcomes.
- Orthobiologic treatments like platelet-rich plasma (PRP) offer less invasive alternatives for select surgical candidates.
- Concerns exist that orthobiologics might delay surgery, increasing overall healthcare costs, but comparative real-world data is limited.
Purpose of the Study:
- To compare the real-world healthcare utilization and costs of platelet-rich plasma (PRP) injections versus traditional surgical interventions for degenerative lumbar spine conditions.
- To evaluate the rate of subsequent surgeries following PRP treatment compared to lumbar fusion or decompression procedures.
Main Methods:
- A retrospective observational study utilized linked commercial insurance claims and an orthobiologic treatment registry.
- Adult patients with lumbar degenerative disc disease (DDD) meeting surgical criteria were included, comparing PRP (with or without BMAC) to lumbar fusion or laminectomy, foraminotomy, discectomy, and facetectomy (LFDF).
- Propensity score matching balanced cohorts; outcomes assessed spine-related resource use and aggregate costs at 12-48 months.
Main Results:
- After matching, PRP cohorts (133 patients vs. fusion, 198 vs. LFDF) showed low rates of subsequent surgery through 24 months.
- PRP patients had lower rates of postoperative imaging, home health, and outpatient visits compared to surgical groups.
- Mean aggregate costs were significantly lower for PRP at 12 and 24 months, driven by lower index procedure and reoperation costs.
Conclusions:
- For select degenerative spine patients meeting surgical criteria, PRP is linked to reduced healthcare utilization and costs compared to lumbar fusion or LFDF.
- No evidence suggests PRP increases progression to surgery, supporting its use as an alternative for appropriate candidates.
- Limitations include potential selection bias and lack of patient-reported outcomes.
