Soaring spinal implant costs have made it increasingly difficult to perform spine services profitably in our hospital system. Our spinal implant budget increased nearly 11 times over a five-year period, from $380,000 in 2000 to $4.1 million in 2005, while our spine surgical volume increased by only 63 percent, from 722 cases in 2000 to 1,354 in 2005. Here's how we're keeping costs under control.