Cost effectiveness of minimally invasive spine surgery: 5 key studies


Here are five studies published in the last five years about cost effectiveness for minimally invasive surgery.

1. A 2016 study published in Spine compares the quality and economic impact of minimally invasive and open TLIF and PLIF for degenerative lumbar conditions. The study found there wasn't a significant difference in operative time between the two groups. The MIS patients reported less blood loss than the open group and patients in the open group stayed longer at the hospital on average. The MIS group reported cost savings from 2.5 percent to 29.3 percent.


2. In 2013, Neurosurgery Focus published a literature review including 12,425 patients and comparing open and minimally invasive spine surgery. The study authors found the average length of stay for MIS spine surgery patients ranged from less than a day to 5.1 days while the average length of stay for open procedures was 1.53 days to 12 days. The study also reported a cost difference between the two procedures of 2.54 percent to 33.68 percent.


3. The Spine Journal also published a study in 2013 comparing open and minimally invasive procedures for TLIF. The study authors found surgical time was shorter on average for the MIS procedures — 115.8 minutes, compared with 186 minutes for the open procedures. The MIS procedures reported $19,512 in direct hospital costs, compared with $23,550 for the open group. Implant costs were similar in both groups — around $13,700 — but accounted for two-thirds of the direct MIS costs and just about one-half of the open group costs.


4. Two studies released last year examined the cost-effectiveness of minimally invasive sacroiliac joint fusion using SI-Bone's iFuse Implant System. The studies reported a five-year gain in quality of life at 0.74 quality-adjusted life years and the incremental cost was $9,833, corresponding with an incremental cost-effectiveness ratio of $13,313 per QALY gained. The second study examined chronic low back pain patients who were considered candidates for lumbar fusion. When the patients had their SI joint considered for diagnosis, the cost model predicted $3,100 expected two-year direct healthcare cost savings compared to those who didn't have the SI joint considered.


5. A 2014 study published in the Journal of Neurosurgery compared open anterior cervical discectomy and fusion to minimally invasive posterior cervical foraminotomy for radiculopathy patients. The study authors found the direct cost for the ACDF patients was $8,192 on average, compared with $4,320 for the PCF patients. There were also significant differences in the cost components for direct costs and operating room supply costs, according to the study abstract.


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