{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:55:24Z","timestamp":1791230124884,"version":"4.1.0"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Efforts to examine the value of care\u2014combining both costs and quality\u2014are gaining importance in the current health care climate. This thrust is particularly evident in treating common spinal disease where both incidences and costs are generally high and practice patterns are variable. It is often challenging to obtain direct surgical costs for these analyses, which hinders the understanding of cost drivers and cost variation. Using a novel tool, the authors sought to understand the costs of posterior lumbar arthrodesis with interbody devices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The Value Driven Outcomes (VDO) database at the University of Utah was used to evaluate the care of patients who underwent open or minimally invasive surgery (MIS), 1- and 2-level lumbar spine fusion (Current Procedural Terminology code 22263). Patients treated from January 2012 through June 2017 were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 276 patients (mean age 58.9 \u00b1 12.4 years) were identified; 46.7% of patients were men. Most patients (82.2%) underwent 1-level fusion. Thirteen patients (4.7%) had major complications and 11 (4.1%) had minor complications. MIS (\u03b2 = 0.16, p = 0.002), length of stay (\u03b2 = 0.47, p = 0.0001), and number of operated levels (\u03b2 = 0.37, p = 0.0001) predicted costs in a multivariable analysis. Supplies and implants (55%) and facility cost (36%) accounted for most of the expenditure. Other costs included pharmacy (7%), laboratory (1%), and imaging (1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These results provide direct cost accounting for lumbar fusion procedures using the VDO database. Efforts to improve the value of lumbar surgery should focus on high cost areas, i.e., facility and supplies\/implant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2018.1.focus17724","type":"journal-article","created":{"date-parts":[[2018,5,1]],"date-time":"2018-05-01T03:36:51Z","timestamp":1525145811000},"page":"E10","source":"Crossref","is-referenced-by-count":41,"title":["Assessment of cost drivers and cost variation for lumbar interbody fusion procedures using the Value Driven Outcomes database"],"prefix":"10.3171","volume":"44","author":[{"given":"Spencer","family":"Twitchell","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Karsy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Reese","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T.","family":"Couldwell","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine J","first-page":"2710","article-title":"Cost savings analysis of intrawound vancomycin powder in posterior spinal surgery","volume":"14","author":"Emohare O","year":"2014","unstructured":"Emohare O, Ledonio CG, Hill BW, Davis RA, Polly DW Jr, Kang MM: Cost savings analysis of intrawound vancomycin powder in posterior spinal surgery. 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Rockville, MD: Agency for Healthcare Research and Quality, 2014 (https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb170-Operating-Room-Procedures-United-States-2011.jsp) [Accessed March 8, 2018]"},{"key":"b25","series-title":"Eur Spine J","first-page":"678","article-title":"A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan","volume":"27","author":"Yagi M","year":"2018","unstructured":"Yagi M, Ames CP, Keefe M, Hosogane N, Smith JS, Shaffrey CI, : A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan. 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JAMA 316:1061\u20131072, 2016"},{"key":"b14","series-title":"Spine (Phila Pa 1976)","first-page":"2905","article-title":"Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion","volume":"32","author":"Levin DA","year":"2007","unstructured":"Levin DA, Bendo JA, Quirno M, Errico T, Goldstein J, Spivak J: Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion. Spine (Phila Pa 1976) 32:2905\u20132909, 2007"},{"issue":"22 Suppl 1","key":"b15","series-title":"Spine (Phila Pa 1976)","first-page":"S65","article-title":"Is minimal access spine surgery more cost-effective than conventional spine surgery?","volume":"39","author":"Lubelski D","year":"2014","unstructured":"Lubelski D, Mihalovich KE, Skelly AC, Fehlings MG, Harrop JS, Mummaneni PV, : Is minimal access spine surgery more cost-effective than conventional spine surgery? 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Rockville, MD: Agency for Healthcare Research and Quality, 2014 (https:\/\/hcup-us.ahrq.gov\/reports\/statbriefs\/sb170-Operating-Room-Procedures-United-States-2011.jsp) [Accessed March 8, 2018]"},{"key":"b25","series-title":"Eur Spine J","first-page":"678","article-title":"A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan","volume":"27","author":"Yagi M","year":"2018","unstructured":"Yagi M, Ames CP, Keefe M, Hosogane N, Smith JS, Shaffrey CI, : A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan. 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