Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA; Department of Orthopedic Surgery, Mayo Clinic, Phoenix, Arizona, USA.
Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona, USA.
World Neurosurg. 2022 Sep;165:e191-e196. doi: 10.1016/j.wneu.2022.05.131. Epub 2022 Jun 18.
Lumbar fusions are commonly performed spinal procedures. Despite this, publicly available lumbar fusion procedural and monetary data are sparse. This study aimed to evaluate trends in utilization and reimbursement for Medicare patients from 2000-2019.
Medicare National Summary Data Files were used. Data were collected for true physician reimbursements and procedural rates for posterolateral fusion, anterior lumbar interbody fusion, posterior lumbar interbody fusion (PLIF), and combined PLIF and posterolateral fusion from 2000-2019. Reimbursement was adjusted to inflation utilizing the 2019 Consumer Price Index.
From 2000-2019, 1,266,942 lumbar fusion procedures were billed to Medicare Part B. Annual number of lumbar interbody fusion procedures increased by 57,740 procedures (+95%) from 61,017 in 2000 to 118,757 in 2019. This change in annual volume varied by procedure type, with posterolateral fusion increasing from 24,873 procedures in 2000 to 45,665 procedures in 2019 (+20,792, +83.59%), anterior lumbar interbody fusion increasing from 4227 in 2000 to 29,285 procedures in 2019 (+25,058, 592.81%), PLIF increasing from 5579 procedures in 2000 to 5628 procedures in 2019 (+49, +0.88%), and combined PLIF and posterolateral fusion increasing from 26,338 procedures in 2012 to 38,179 procedures in 2019 (+11,841, +44.96%). The mean inflation-adjusted reimbursement decreased for posterolateral fusion from $1662.96 to $1245.85 (-$417.11, -25.08%), anterior lumbar interbody fusion from $1159.45 to $750.33 (-$409.12, -35.29%), PLIF from $1225.02 to $1223.72 (-$1.3, -0.11%), and combined PLIF and posterolateral fusion from $1541.59 per procedure in 2012 to $1467.08 per procedure in 2019.
Lumbar fusions have increased in the last 2 decades, although reimbursement for all procedures has decreased. Knowledge of these trends is important to ensure adequate resource allocation to surgeons as treating lumbar pathologies becomes more common among the aging Medicare population.
腰椎融合术是一种常见的脊柱手术。尽管如此，公开的腰椎融合术程序和货币数据却很少。本研究旨在评估 2000-2019 年期间 Medicare 患者的使用和报销趋势。
使用 Medicare 国家汇总数据文件。从 2000-2019 年收集了真正的医生报销和后外侧融合、前路腰椎间融合术、后路腰椎间融合术（PLIF）和 PLIF 与后外侧融合联合的程序费率数据。使用 2019 年消费者价格指数对报销进行了通货膨胀调整。
2000-2019 年，1266942 例腰椎融合术向 Medicare 第 B 部分收费。腰椎间融合术的年手术量增加了 57740 例（+95%），从 2000 年的 61017 例增加到 2019 年的 118757 例。这种年度手术量的变化因手术类型而异，后外侧融合术从 2000 年的 24873 例增加到 2019 年的 45665 例（+20792，+83.59%），前路腰椎间融合术从 2000 年的 4227 例增加到 2019 年的 29285 例（+25058，+592.81%），PLIF 从 2000 年的 5579 例增加到 2019 年的 5628 例（+49，+0.88%），PLIF 和后外侧融合联合术从 2012 年的 26338 例增加到 2019 年的 38179 例（+11841，+44.96%）。后外侧融合术的平均通货膨胀调整后报销从 1662.96 美元降至 1245.85 美元（-417.11，-25.08%），前路腰椎间融合术从 1159.45 美元降至 750.33 美元（-409.12，-35.29%），PLIF 从 1225.02 美元降至 1223.72 美元（-1.3，-0.11%），PLIF 和后外侧融合联合术的报销从 2012 年的 1541.59 美元/例降至 2019 年的 1467.08 美元/例。
在过去的 20 年里，腰椎融合术的数量有所增加，尽管所有手术的报销都有所减少。了解这些趋势对于确保外科医生获得足够的资源分配很重要，因为随着 Medicare 人群老龄化，治疗腰椎疾病变得越来越普遍。
