Index Surgery Cost of Fluoroscopic Freehand Versus Robotic-Assisted Pedicle Screw Placement in Lumbar Instrumentation: An Age, Sex, and Approach-Matched Cohort Comparison.
Journal of the American Academy if Orthopaedic Surgeons. Global Research & Reviews
BACKGROUND: Spine surgery costs are notoriously high, and there are already criticisms and concerns over the economic effects. There is no consensus on cost variation with robot-assisted spine fusion (rLF) compared with a manual fluoroscopic freehand (fLF) approach. This study looks to compare the early costs between the robotic method and the freehand method in lumbar spine fusion.
METHODS: rLFs by one spine surgeon were age, sex, and approach-matched to fLF procedures by another spine surgeon. Variable direct costs, readmissions, and revision surgeries within 90 days were reviewed and compared.
RESULTS: Thirty-nine rLFs were matched to 39 fLF procedures. No significant differences were observed in clinical outcomes. rLF had higher total encounter costs (P < 0.001) and day-of-surgery costs (P = 0.005). Increased costs were mostly because of increased supply cost (0.0183) and operating room time cost (P < 0.001). Linear regression showed a positive relationship with operating room time and cost in rLF (P < 0.001).
CONCLUSION: rLF is associated with a higher index surgery cost. The main factor driving increased cost is supply costs, with other variables too small in difference to make a notable financial effect. rLF will become more common, and other institutions may need to take a closer financial look at this more novel instrumentation before adoption.
Ezeokoli EU, Pfennig M, John J, Gupta R, Khalil JG, Park DK. Index surgery cost of fluoroscopic freehand versus robotic-assisted pedicle screw placement in lumbar instrumentation: an age, sex, and approach-matched cohort comparison. J Am Acad Orthop Surg Glob Res Rev. 2022 Dec 2;6(12):e22.00137. doi: 10.5435/JAAOSGlobal-D-22-00137. PMID: 36732310.