A new study published in The Spine Journal examines the economics associated with CT-based navigation and conventional fluoroscopy for placing pedicle screws during spine surgery.
The researchers examined 502 patients who had 5,132 pedicle screws placed. There were 2,682 screws placed in 253 patients in the treatment group using the O-arm imaging and StealthStation S7 Navigation Systems from Medtronic. There were 2,450 screws placed in 249 patients in the control group.
The researchers calculated capital costs, annual maintenance costs and reoperation costs for each case. The researchers found:
1. Accuracy rates were 92.5 percent in the treatment group and 86.9 percent in the control group.
2. One year after treatment, two patients required revision surgery in the treatment group while 15 patients — 6 percent — required reoperation in the control group.
3. The incremental cost effectiveness ratio was $15,961 per reoperation avoided for the computer-assisted group. Based on the $12,618 reoperation cost, the new technology becomes cost-saving for centers performing more than 254 instrumented spinal procedures per year.
4. The researchers concluded computer-assisted spinal surgery could reduce reoperation rates and lower associated costs. It could also have policy implications going forward.
5. The costs to acquire and maintain the technology can be offset by cost-savings from reduced reoperations. "Our cost-effectiveness analysis showed that for high volume centers with a similar case complexity to the studied population, this technology is economically justified," concluded the study authors.