Abstract:
STUDY DESIGN:Retrospective review. OBJECTIVE:To define the geographic variation in costs of anterior cervical discectomy and fusion (ACDF) and posterolateral fusion (PLF). SUMMARY OF BACKGROUND DATA:ACDF and lumbar PLF are common procedures that are used in the treatment of spinal pathologies. To optimize value, both the benefits and costs of an intervention must be quantified. Data on costs are scarce in comparison with data on total charges. This study aims at defining the costs of ACDF and PLF and describing the geographic variation within the United States. METHODS:Medicare Provider Utilization and Payment data were used to investigate the costs associated with ACDF, PLF, and total knee arthroplasty (TKA). Average total costs of the procedures were compared by state and geographic region. RESULTS:Combined professional and facility costs for a single-level ACDF had a national mean of $13,899. Total costs for a single-level PLF had a mean of $25,858. Total costs for a primary TKA had a national mean of $13,039. The cost increased to an average of $22,138 for TKA with major comorbidities. Analysis of geographic trends showed statistically significant differences in total costs of PLF, TKA, and TKA, with major complications or comorbidities between geographic regions (P < 0.01 for all). CONCLUSION:Three of the 4 procedures (PLF, TKA, and TKA with major complications or comorbidities) showed statistically significant variation in cost between geographic regions. The Midwest provided the lowest cost for all procedures. Similar geographic trends in the cost of spinal fusions and TKAs suggest that these trends may not be limited to spine-related procedures. Surgical costs were found to correlate with cost of living but were not associated with the population of the state. These data shed light on the actual cost of common surgical procedures throughout the United States and will allow further progress toward the development of cost-effective, value-driven care. LEVEL OF EVIDENCE:3.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Goz V,Rane A,Abtahi AM,Lawrence BD,Brodke DS,Spiker WRdoi
10.1097/BRS.0000000000001022subject
Has Abstractpub_date
2015-09-01 00:00:00pages
1380-9issue
17eissn
0362-2436issn
1528-1159journal_volume
40pub_type
杂志文章相关文献
SPINE文献大全abstract::: Johann Peter Frank (1745-1821) is generally known as one of the founders of the modern Hygiene and Public Health. It is less known his contribution in investigating the pathogenesis of spinal disorders. In his "De Vertebralis Columnae in Morbis Dignitate" (1791), Frank first proposed to use the Latin term "rhachialg...
journal_title:Spine
pub_type: 历史文章,杂志文章
doi:10.1097/BRS.0000000000003074
更新日期:2019-10-01 00:00:00
abstract:STUDY DESIGN:This case study describes the usefulness of high-resolution 18F-2-fluoro-deoxy-D-glucose (18FDG)-positron emission tomography (PET) for metabolic neuroimaging of the cervical spinal cord in patients with compressive myelopathy. OBJECTIVE:To examine whether 18FDG-PET imaging could visualize deterioration o...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199907150-00010
更新日期:1999-07-15 00:00:00
abstract:STUDY DESIGN:Validation of a performance scale. OBJECTIVE:The purpose of this study is to investigate adaptation, validity, and reliability of the Turkish version of the Back Performance Scale (BPS). SUMMARY OF BACKGROUND DATA:Low back pain affects people of all ages and causes pain, disability, and psychosocial prob...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002771
更新日期:2019-01-01 00:00:00
abstract:STUDY DESIGN:Retrospective cohort study. OBJECTIVE:The aims of this study were to (1) compare patient and procedure-specific characteristics among those who had short versus long hospital stays and (2) identify independent risk factors that may correlate with extended length of hospital stay (LOS) in patients with ado...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000002919
更新日期:2019-05-15 00:00:00
abstract:STUDY DESIGN:A review of 60 surgical cases for correction of scoliosis, during which neuromotor evoked potentials and somatosensory evoked potentials were monitored. OBJECTIVES:To determine the validity and reliability of intraoperative neuromotor evoked potential monitoring in cases of scoliosis, where damage to the ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199910010-00012
更新日期:1999-10-01 00:00:00
abstract::The activity of the erector spinae muscles and the changes in lumbar curvature were measured in 11 subjects in a range of commonly adopted postures to see if there were any consistent trends. Surface electrodes were used to measure back muscle activity and lumbar curvature was measured using electronic inclinometers. ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198802000-00012
更新日期:1988-02-01 00:00:00
abstract:STUDY DESIGN:Osteoporotic human cadaveric thoracic vertebral bodies and vertebral bodies from mature sheep were used as model systems to assess coral resorption and new bone formation after injection of coral granules. OBJECTIVE:To evaluate the use of natural coral exoskeleton, an osteoconductive material, for the fil...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200005010-00006
更新日期:2000-05-01 00:00:00
abstract:STUDY DESIGN:Retrospective review of pediatric patients with vertebral and spinal cord tumors. OBJECTIVES:To identify clinical and radiographic features of diagnostic importance, and to evaluate the effectiveness of surgical treatment with respect to complications in pediatric patients with vertebral and spinal cord t...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.BRS.0000085323.71376.42
更新日期:2003-10-15 00:00:00
abstract::The ability of Elvey's "brachial plexus tension test" to identify pain referred from the cervical region was investigated in 50 patients with unilateral shoulder and upper arm pain: 25 reported symptoms commencing after open heart surgery, indicating a high probability of referred pain due to that procedure; 25 were a...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199401000-00006
更新日期:1994-01-01 00:00:00
abstract:STUDY DESIGN:Experimental biomechanics of multilevel segments with 0, 1, 2, and 3 vertebral levels of polymethylmethacrylate augmentation. OBJECTIVE:To compare multilevel spinal segments with different numbers (0, 1, 2, and 3) of vertebral levels augmented with polymethylmethacrylate. SUMMARY OF BACKGROUND DATA:The s...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000207466.40955.31
更新日期:2006-04-01 00:00:00
abstract:STUDY DESIGN:Single-center retrospective case series. OBJECTIVE:To compare outcomes of instrumented fusion and two methods of decompression for degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA:There is no consensus on the surgical indications or optimum techniques for lumbar degenerative spondylolisthesis. ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001688
更新日期:2017-01-01 00:00:00
abstract:STUDY DESIGN:A case report of traumatic atlanto-occipital dislocation managed by transarticular screw fixation. OBJECTIVES:To present a case with initial failed wire fixation but successful reduction and fixation with transarticular screw fixation and occipitocervical plate stabilization. SUMMARY OF BACKGROUND DATA:A...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200103150-00030
更新日期:2001-03-15 00:00:00
abstract:STUDY DESIGN:Case report. OBJECTIVE:To report a case of an acute intracranial subdural hematoma that formed due to cerebrospinal fluid (CSF) leak following lumbar surgery. SUMMARY OF BACKGROUND DATA:Intracranial hypotension may occur when CSF is removed from the subarachnoid space. Intracranial subdural hematoma form...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000192208.66360.29
更新日期:2005-12-15 00:00:00
abstract:STUDY DESIGN:Meta-analysis methodology was extended to derive comparative effectiveness information on spinal manipulation for low back pain. OBJECTIVE:Determine relative effectiveness of spinal manipulation therapies (SMTs), medical management, physical therapies, and exercise for acute and chronic nonsurgical low ba...
journal_title:Spine
pub_type: 杂志文章,meta分析
doi:10.1097/BRS.0000000000000230
更新日期:2014-04-01 00:00:00
abstract:STUDY DESIGN:Concurrent, prospective, randomized, and observational cohort study. OBJECTIVE:To assess the 4-year outcomes of surgery versus nonoperative care. SUMMARY OF BACKGROUND DATA:Although randomized trials have demonstrated small short-term differences in favor of surgery, long-term outcomes comparing surgical...
journal_title:Spine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/BRS.0b013e31818ed8f4
更新日期:2008-12-01 00:00:00
abstract:STUDY DESIGN:This study analyzed the correlation between the atlantoaxial instability (especially sagittal plane rotatory instability) and myelopathy. Thirty-four patients with os odontoideum were reviewed in clinical symptoms and radiographs. OBJECTIVES:The results were correlated to provide a rationale for the genes...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199606150-00007
更新日期:1996-06-15 00:00:00
abstract::Cyclic axial compression-tension tests and cyclic torsional tests were performed on ten fresh human L4-5 functional spinal units to investigate the structural effects of the posterior elements on the mechanical properties of L4-5 functional spinal units. The stiffness of the functional spinal unit increased with the i...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199211000-00014
更新日期:1992-11-01 00:00:00
abstract:STUDY DESIGN:We used the Climent Quality of Life for Spinal Deformities Scale prospectively in a nonrandomized prospective comparative cohort of operative versus observational management of adolescent idiopathic scoliosis. OBJECTIVE:To compare the change in disease-specific quality of life associated with operating on...
journal_title:Spine
pub_type: 临床试验,杂志文章
doi:10.1097/BRS.0b013e31815a51cd
更新日期:2007-11-15 00:00:00
abstract:STUDY DESIGN:Retrospective review of 750 consecutive multilevel cervical spine decompression surgeries performed by a single spine surgeon. OBJECTIVE:To determine the incidence of C5 palsy in a large consecutive series of multilevel cervical spine decompression procedures. SUMMARY OF BACKGROUND DATA:Palsy of the C5 n...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e318219cfe9
更新日期:2012-02-01 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:Evaluate the relationship among the neurologic status, the Thoracolumbar Injury Classification System (TLICS) score, and the Magerl/AO classification system. SUMMARY OF THE BACKGROUND DATA:A wide range of classification schemes for thoracic and lumbar spine trauma have been...
journal_title:Spine
pub_type: 杂志文章,多中心研究
doi:10.1097/BRS.0b013e3181c95047
更新日期:2011-01-01 00:00:00
abstract::Biopsy or subtotal resection followed by radiation for intramedullary astrocytomas of the spinal cord offer palliation but not cure. A treatment modality using an ultrasonic suction device has revolutionized the treatment of these tumors and has been extended to include the treatment of intramedullary tumors involving...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198710000-00006
更新日期:1987-10-01 00:00:00
abstract::Spinal cord evoked potentials were recorded from spinous processes of the lumbar, thoracic, and cervical levels of the spinal column of normal cats in response to direct stimulation of the sciatic nerve and subcutaneous stimulation of the posterior tibial nerve. The typical primary response was altered by changes in l...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-197911000-00007
更新日期:1979-11-01 00:00:00
abstract:STUDY DESIGN:A literature-based review. OBJECTIVES:To review management and controversies and to present authors recommendations. SUMMARY OF BACKGROUND DATA:There is considerable controversy regarding indication for surgery, role for decompression alone, and decompression with fusion with or without instrumentation. ...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/01.brs.0000155579.88537.8e
更新日期:2005-03-15 00:00:00
abstract:STUDY DESIGN:Retrospective study. OBJECTIVE:Compare outcomes of different treatment methods for intraspinal synovial cysts. SUMMARY OF BACKGROUND DATA:Intraspinal synovial cysts are cited as an increasing cause of back pain and radiculopathy. To date, few studies have compared outcomes of differing treatment methods ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181bdafed
更新日期:2010-05-01 00:00:00
abstract:STUDY DESIGN:Recent literature regarding the psychological impact of scoliosis was reviewed. OBJECTIVE:To determine the impact of scoliosis on health-related quality of life (HRQL), psychosocial functioning, and body image to improve patient outcomes. SUMMARY OF BACKGROUND DATA:Adolescents and adults with adolescent ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000249555.87601.fc
更新日期:2006-12-15 00:00:00
abstract:STUDY DESIGN:A retrospective study by an independent observer of a consecutive series of 67 cases of adolescent idiopathic scoliosis presenting with a King II curve pattern. OBJECTIVES:To demonstrate the validity of a selective thoracic fusion as a treatment of King II curves with special attention to immediate postop...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199810010-00005
更新日期:1998-10-01 00:00:00
abstract:STUDY DESIGN:A retrospective database study. OBJECTIVE:The goal of this study was to (1) evaluate the trends in the use of electromyography (EMG) for instrumented posterolateral lumbar fusions (PLFs) in the United States and (2) assess the risk of neurological injury following PLFs with and without EMG. SUMMARY OF BA...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001980
更新日期:2017-07-01 00:00:00
abstract:STUDY DESIGN:An independent retrospective review of 37 patients undergoing 39 anteroposterior lumbar fusions for lumbar pseudarthrosis repair between 1984 and 1990. OBJECTIVES:To evaluate radiographically and functionally the results of the combined anteroposterior fusion for the management of symptomatic lumbar pseud...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200001010-00021
更新日期:2000-01-01 00:00:00
abstract:STUDY DESIGN:System validation study. OBJECTIVE:To develop and validate a motion sensor system for measuring cervical spine motion over extended time periods. SUMMARY OF BACKGROUND DATA:Many studies using different methodologies have tried to estimate cervical spine motion. These have mostly been carried out in a lab...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e318145a93a
更新日期:2007-09-01 00:00:00
abstract:STUDY DESIGN:Report of the use of one segmental artery from the left renal artery as inflow source for reconstructing a spine with recalcitrant osteomyelitis. OBJECTIVE:To describe one difficult case of spinal osteomyelitis and our reconstruction procedure. SUMMARY OF BACKGROUND DATA:The use of a vascularized fibular...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181ecbfa1
更新日期:2010-12-01 00:00:00