Objective:
To analyze trends in lumbar fusion procedures, costs, and indications in the United States from 2002 to 2023, highlighting their clinical significance.
Approach:
- Inflation-adjusted inpatient hospital costs for lumbar fusion increased from $3.86 billion in 2002 to $14.1 billion in 2023.
- The age-adjusted rate of inpatient lumbar fusion peaked at 89.9 per 100,000 individuals in 2016, then declined to 80 per 100,000 by 2023.
- Combined anterior-posterior fusions rose from 19.6% in 2016 to 41.1% in 2023, while single-level single-column fusions decreased from 43.7% to 25.1%.
- Mean per-procedure inpatient costs increased from $25,849 to $45,458 from 2002 to 2023.
- Fusion rates increased for scoliosis (271.2%), spinal stenosis (218%), and spondylolisthesis (83.4%), while rates for disc degeneration and herniation declined by over 80%.
- Lumbar fusion procedures performed in hospital-owned outpatient facilities increased from 2.1% in 2016 to 9.8% in 2022.
- Administrative data lacks clinical detail such as severity of pain, functional outcomes, or neurologic symptoms, limiting assessment of procedure appropriateness or comparative effectiveness.
- The lack of clinical detail may impact the interpretation of the findings.
Key Findings:
Interpretation:
The increase in costs and complexity of lumbar fusion procedures highlights a shift in surgical practices and indications, necessitating further investigation into clinical outcomes and their implications.
Limitations:
Conclusion:
Further research is needed to evaluate the clinical advantages of multilevel and anterior-posterior fusion procedures, particularly regarding readmission rates, complications, and patient-reported outcomes, emphasizing the need for comprehensive data.
Sources:
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
