Educational Programs May Reduce Unnecessary Costs in Spine Surgery

An educational program for surgeons can reduce unnecessary hardware “explantations” during spinal surgery, according to a study published in Spine.

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Researcher analyzed the before and after costs and frequencies of explantation for single-level anterior discectomy and fusions performed in 2010 at the same institution by the same surgeons.

From January through April, surgeons were unaware of concerns regarding explantation. At the end of April 2010, spinal surgeons were educated about explantation costs and frequency at two meetings. Explantation costs and frequencies for the first four months of 2010 were compared with those for the last eight months as well as with the results from 2009.

Key Findings Include:
•    Prior to surgeon education, instrumentation was explanted in about 45 percent of the cases, whereas after education explantation occurred in 16 percent of the cases.
•    The explantation rate was lower after education for screws, about 12 percent versus about 8 percent; plates was about 9 percent versus 0 percent; and allograft spacers, about 7 percent versus about 3 percent.
•    In 2010, the overall cost of explanted devices as a percentage of implanted devices was also lower after surgeon education (5 percent) than before surgeon education in 2010 (20 percent) or in 2009 (9 percent).


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