A new article published in The Spine Journal examines the geographic differences in surgical treatment of lumbar spondylolisthesis.
The study authors examined 67,077 patients with lumbar spondylolisthesis who received laminectomy or laminectomy with arthrodesis at various sites across the country. Study authors observed:
1. Most — 91.8 percent — of the patients received arthrodesis.
2. The state with the highest arthrodesis rate, South Dakota, reported 97.5 percent of the cases included arthrodesis; the lowest rate was reported in Oregon, at 81.5 percent.
3. There was a variation in cost across the nation as well; in Alabama, the initial surgical treatment cost is $32,485, compared with $78,433 in Colorado.
4. The gap in postoperative costs for two years after surgery is also large. In Arkansas, the two-year postoperative costs are $15,612, compared to $34,096 in New Jersey.
5. Average hospital stays vary across the country, from 4.5 days in Washington D.C. to 2.6 days in Arkansas.
6. The 30-day complication rates and readmission rates are different based on the state of treatment. The complication rates range from 9.5 percent in South Dakota to 22.4 percent in Maryland while the readmission rates range from 2.5 percent in South Dakota to 13.6 percent in Connecticut.
7. Reoperation rates vary greatly as well, from 1.8 percent in Maine to 12.7 percent in Alabama.
"The variation remains pronounced after accounting for patient-level demographic differences," concluded study authors.