Health Care Outcomes and Costs Associated With Cervical and Lumbar Spinal Fusion Surgeries in the United States: A Retrospective Claims Database Study.

Abstract

Descriptive, retrospective cohort study. To descriptively evaluate the 2-year health care burden post cervical and lumbar fusion surgeries using real-world data. Reoperation, infection, and pseudarthrosis are common adverse events after cervical and lumbar fusion procedures. This was a descriptive, retrospective cohort study using Merative™ MarketScan® Commercial Claims Database (October 1, 2015 to October 31, 2022). International Classification of Diseases-Tenth Revision (ICD-10) codes were used to identify and study outcomes of adults who underwent cervical-only (N=28,674) or lumbar-only (N=14,527) fusion surgery. The outcomes included incidence and cost of reoperations, pseudarthrosis, and infection post cervical and lumbar spinal fusion surgery. At 2-year follow-up, cervical and lumbar reoperations were performed in 11.6% and 11.0% of cases. A third of cervical and 57% of lumbar reoperation cases had spinal complications identified within the 90 days before and including the reoperation admission. Following cervical and lumbar fusion index surgeries, 2-year pseudarthrosis was reported in 3.9% and 5.6%, and infection in 2.2% and 4.3% of cases, respectively. ​Two-year postoperative health care costs associated with pseudarthrosis or infection following cervical fusion averaged $33,055 and $108,173, and those following lumbar fusion averaged $32,303 and $80,539, respectively. ​For patients with reoperations, the 2-year postoperative health care costs associated with cervical and lumbar fusion were $49,354 and $73,604, respectively.​. Using modern real-world data, our descriptive study suggested significant increased health care costs associated with adverse outcomes after cervical and lumbar fusion surgery. Innovative technologies that mitigate the risk of adverse outcomes after spine fusion have the potential to reduce costs postsurgeries.