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. 2017 Sep 15;42(18):1398-1404.
doi: 10.1097/BRS.0000000000002118.

Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database

Paolo A Cortesi  1 , Roberto Assietti  2 , Fabrizio Cuzzocrea  3 , Domenico Prestamburgo  4 , Mauro Pluderi  5 , Paolo Cozzolino  1 , Patrizia Tito  2 , Roberto Vanelli  3 , Davide Cecconi  4 , Stefano Borsa  5 , Giancarlo Cesana  1 , Lorenzo G Mantovani  1
Affiliations

Epidemiologic and Economic Burden Attributable to First Spinal Fusion Surgery: Analysis From an Italian Administrative Database

Paolo A Cortesi et al. Spine (Phila Pa 1976). .

Abstract

Study design: Retrospective large population based-study.

Objective: Assessment of the epidemiologic trends and economic burden of first spinal fusions.

Summary of background data: No adequate data are available regarding the epidemiology of spinal fusion surgery and its economic impact in Europe.

Methods: The study population was identified through a data warehouse (DENALI), which matches clinical and economic data of different Healthcare Administrative databases of the Italian Lombardy Region. The study population consisted of all subjects, resident in Lombardy, who, during the period January 2001 to December 2010, underwent spinal fusion surgery (ICD-9-CM codes: 81.04, 81.05, 81.06, 81.07, and 81.08). The first procedure was used as the index event. We estimated the incidence of first spinal fusion surgery, the population and surgery characteristics and the healthcare costs from the National Health Service's perspective. The analysis was performed for the entire population and divided into the main groups of diagnosis.

Results: The analysis identified 17,772 [mean age (SD): 54.6 (14.5) years, 55.3% females] spinal fusion surgeries. Almost 67% of the patients suffered from a lumbar degenerative disease. The incidence rate of interventions increased from 11.5 to 18.5 per 100,000 person-year between 2001 and 2006, and was above 20.0 per 100,000 person-year in the last 4 years. The patients' mean age increased during the observational time period from 48.1 to 55.9 years; whereas the median hospital length of stay reported for the index event decreased. The average cost of the spinal fusion surgery increased during the observational period, from &OV0556; 4726 up to &OV0556; 9388.

Conclusion: The study showed an increasing incidence of spinal fusion surgery and costs from 2001 to 2010. These results can be used to better understand the epidemiological and economic burden of these interventions, and help to optimize the resources available considering the different clinical approaches accessible today.

Level of evidence: 4.

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References

    1. Rihn JA, Currier BL, Phillips FM, et al. Defining the value of spine care. J Am Acad Orthop Surg 2013; 21:419–426.
    1. Martin BI, Deyo RA, Mirza SK, et al. Expenditures and health status among adults with back and neck problems. JAMA 2008; 299:656–664.
    1. Martin BI, Turner JA, Mirza SK, et al. Trends in health care expenditures, utilization, and health status among US adults with spine problems, 1997–2006. Spine (Phila Pa 1976) 2009; 34:2077–2084.
    1. Zaina F, Tomkins-Lane C, Carragee E, et al. Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database Syst Rev 2016; 1:CD010264.
    1. Peul WC, Moojen WA. Fusion for lumbar spinal stenosis: safeguard or superfluous surgical implant? N Engl J Med 2016; 374:15.

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