Decompression With or Without Fusion for Lumbar Stenosis: A Cost Minimization Analysis

Study Design. Retrospective database review. Objective. Compare 1-year episode of care costs between single-level decompression and decompression plus fusion for lumbar stenosis. Summary of Background Data. Lumbar stenosis is the most common indication for surgery in patients over 65. Medicare direct hospital costs for lumbar surgery reached $1.65 billion in 2007. Despite stenosis being a common indication for surgery, there is debate as to the preferred surgical treatment. Cost-minimization analysis is a framework that identifies potential cost savings between treatment options that have similar outcomes. We performed a cost-minimization analysis of decompression versus decompression with fusion for lumbar stenosis from the payer perspective. Methods. An administrative claims database of privately insured patients (Humana) identified patients who underwent decompression (n = 5349) or decompression with fusion (n = 8540) for lumbar stenosis with and without spondylolisthesis and compared overall costs. All patients were identified and costs identified for a 1-year period. Complication rates and costs were described using summary statistics. Results. Mean treatment costs at 1 year after surgery were higher for patients who underwent decompression and fusion compared to patients who underwent decompression alone ($20,892 for fusion vs. $6329 for decompression; P 
Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research