A new study published in Clinical Spine Surgery examines the value of single-level lumbar discectomy.
Study authors examined adult lumbar discectomy cases performed at Cleveland Clinic between October 2009 and August 2013 using administrative billing data. The researchers also gathered health status measures from the Cleveland Clinic Knowledge Program Data Registry. Around 67 percent of the operations were performed in the outpatient setting and 33 percent in the inpatient setting.
Study authors found:
1. There were nine surgeons who performed more than 10 lumbar discectomies over the study period, with the average number being 72.4 operations.
2. The costs associated with lumbar discectomies differed by surgeon, and the only variables correlating with surgical costs were the surgeon and surgery setting.
3. Patient-reported outcomes, including EQ-5D and Pain Disability Questionnaire scores, weren't statistically correlated with surgical costs. However, after performing a multivariate regression, surgical costs were significantly correlated to the average difference in PDQ; the most costly procedures were associated with worse PDQ scores.
4. Study authors found using disposable supplies and implants didn't have an impact on patient outcomes. "Performing an operation using more costly disposable supplies/implants does not seem to improve patient outcomes and should be considered when constructing preference cards and during an operation," concluded the study authors.