The study included 85,640 patients who underwent single-level spinal procedures. They underwent anterior cervical discectomy and fusion, lumbar fusion, lumbar laminectomy or lumbar discectomy. Around 12.66 percent of the patients received intraoperative neuromonitoring. The researchers found:
1. Patients who underwent lumbar laminectomies with neuromonitoring had reduced 30-day neurological complication rates — 0 percent versus 1.18 percent.
2. In patients who underwent ACDF, lumbar fusion or lumbar discectomy, neuromonitoring didn’t correlate with complications. The breakdown in numbers was:
• ACDF: 0.09 percent with neuromonitoring vs. 0.13 percent without
• Lumbar fusion: 0.32 percent with neuromonitoring vs. 0.58 percent without
• Lumbar discectomy: 1.24 percent with neuromonitoring vs. 0.91 percent without
3. The payments increased when neuromonitoring was added:
• ACDF: payments were up 16.2 percent to $3,842
• Lumbar fusion: payments were up 7.8 percent to $3,540
• Lumbar laminectomies: payments were up 24.3 percent to $3,704
• Lumbar discectomies: payments were up 22.5 percent to $2,859
4. There was significant geographic variation in the data, with rates for each procedure hitting as high as:
• ACDF: 61 percent
• Lumbar fusion: 58 percent
• Laminectomies: 22 percent
• Discectomies: 21 percent
5. The higher costs associated with neuromonitoring may have implications for cost-effectiveness. “We saw that total payments increased by much more than the assumed reimbursement in the study [with neuromonitoring],” concluded the study authors.
More articles on spine surgery:
Prospective spine care registries: The next frontier?
SI joint fusion could explode by 2020—5 things to know
What makes spine surgeons apprehensive about the future?
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
