Spinal Surgery
Managing the costs of explanted spine hardware
During spinal surgery, it is sometimes necessary to implant and then remove, or explant, instrumentation in the same procedure. Explantation occurs when an implanted plate or spacer does not fit, or implanted screws are too loose or too short. Explanted instrumentation cannot be reused and must be discarded, adding to…
BMP use up sharply, but outcomes not improved
Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…
A critical eye on Infuse use studies
A leading spine journal is casting a critical eye on industry-supported research that has led to widespread use of Medtronic's controversial bone growth product Infuse. The June 2011 issue of Spine Journal carries a strongly worded editorial about the trial designs, reporting bias, and peer review shortfalls that the authors…
Spinal implant costs decline modestly
Over the 8 years from 2001 to 2009, the cost of a lumbar spinal fusion with implants rose from under $6,000 to over $14,000 per case, with a small decline of 2% between 2008 and 2009. This was the second year in a row that the implant cost per case…
Spinal fusion under the microscope
Lumbar fusion has grown rapidly, skyrocketing by more than 250% in the past 20 years. Costs have risen even faster, by more than 500% in Medicare patients alone, according to a recent study from Dartmouth. Lumbar fusion accounts for almost 50% of all back surgery performed in the US. Now…
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