Predictors Of Outcomes And Cost After Spinal Fusion Surgery And Construction Of Patient Risk Calculators

Orthopedic Surgery has recently been on the rise with more patients undergoing fusion surgery than ever before, especially in the United States. Providing quick relief alongside physical therapy, surgery has become a mainstay for treating spinal degenerative diseases and injury as opposed to the non-surgical options. However, long-term outcomes of spine surgery have been a subject of controversy as studies following patient pain scales and quality of life have shown little long-term benefit to surgery. Moreover, the complications of surgery post-operative can increase patient morbidity and mortality, which is burdensome in an aging surgical population with increasing comorbidities. Furthermore, adverse outcomes burden both the patient and the healthcare systems with added costs. This study looked at the outcomes and cost of Cervical Fusion Surgery and Thoracolumbar Fusion Surgery at a high traffic, tertiary academic center to better understand the patient demographics and comorbidities that are contributing to adverse outcomes. The risks of developing adverse outcomes were compared to a Reference Population in our cohort that had no comorbidities and represented the most common patient demographic. The Charlson Comorbidity Index was used to determine patient comorbidity burden pre-operative as it predicts post-operative adverse outcomes. In addition, cost was determined for the Reference Population as a function of patient demographics and comorbidities. The rates of adverse outcomes and cost were then compared to national averages found in literature. Finally, relative risk calculators that modifiable for individual patient demographics and comorbidities were constructed to predict the risk of post-operative adverse outcomes and cost of future patients undergoing Cervical Fusion Surgery and Thoracolumbar Fusion Surgery at our institution.