OBJECTIVES

: Anterior cervical fusion (ACF) is a common surgery performed for many cervical pathologies. There’s little evidence on the costs incurred when patients require reoperation of their index surgery. This study was designed to evaluate the hospital costs of reoperation at one-year and differences in cost by proxy measures of surgical complexity.

METHODS

: Patients with an ICD-10-PCS code for ACF from Q4 2015 through Q4 2016 were identified in the Premier Healthcare Database. Patient characteristics, one-year reoperation rate and hospital costs at the time of reoperation for ACF were collected. The data were stratified by proxy measures of surgical complexity: number of operated spinal levels and osteoporosis status at index, and Wilcoxon rank-sum test was used to evaluate cost differences by complexity.

RESULTS

: The total cohort size was 30,966 patients. The one-year reoperation rate was 0.7%. When costs were observed by number of levels, there was a statistically significant trend towards higher total cost of care among patients who had a reoperation of two or more levels (2+); the overall total median cost of care for a one-level reoperation was $14,265 versus a 2+ level surgery was $24,009. When the data were stratified by levels and osteoporosis status, there was a non-significant trend towards higher total cost of care for patients with osteoporosis; the overall total median cost of care for a one level surgery with and without osteoporosis was $19,364 and $14,265; for a 2+ level surgery was $33,235 and $23,914.

CONCLUSIONS

: Number of levels treated and osteoporosis status at time reoperation for ACF may drive higher hospital costs. Further analyses are needed to evaluate the relationship between surgical complexity and the costs at the time of reoperative ACF.