Surgeons who are made aware of the costs associated with implanting and removing ill-fitting hardware during spinal surgery can save surgical facilities more than $20,000 a year, according to a study published in the journal Spine.
Researchers at the Albert Einstein College of Medicine in New York City instituted an educational program in 2010 designed to inform surgeons performing single-level discectomy and fusion about the definition and cost of "explantation," the placement and removal of hardware during the same operation. The researchers say hardware is explanted when, for example, implanted plates don't fit or screws are too loose or too short.
From January to April, surgeons were unaware of the researchers' concerns over explantation costs. At the end of April, the researchers educated surgeons about the cost and frequency of explantation and informed them that their explantation rates and costs would be tracked for the remainder of the year.
Explantation rates dropped from 45% to 16% for screws, plates and spacers after the educational sessions, according to the study. In addition, the overall cost of explanted devices fell from 20% to around 6% after surgeons were educated.
Explanted devices are significant contributors to the overall cost of surgery, say the study's authors, who point out that the plates used in their research cost about $1,450 each and the screws about $1,200 per set.
The researchers say their findings are the tip of the iceberg when it comes to controlling implant costs, and push for further research to address ways of reducing implant waste during more complex spine procedures.
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