Single-level lumbar fusion is cost-effective

By Terry Stanton

A study to determine the cost-effectiveness of single-level instrumented posterolateral lumbar fusion at 5 years after surgery found that the procedure falls within an acceptable range both for benefit versus cost and for durability.

The study, presented by Steven D. Glassman, MD, at the AAOS 2010 Annual Meeting, is one of the first to examine this issue at the 5-year postoperative interval. At that point, the direct cost per quality-adjusted life year (QALY) gained was approximately $33,000; when the total work productivity cost was factored in, the direct cost per QALY gained was $54,000 (Table 1). Cost analysis was based on actual reimbursements from third-party payors, including payments for the index procedure, treatment of complications, emergency department outpatient visits, and revision surgery. An analysis was also made based on Medicare reimbursement, yielding a direct cost per QALY gained of $30,000 ($51,000 with indirect costs included).

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