OBJECTIVES: Patient characteristics that may affect outcomes following minimally invasive surgery (MIS) for posterior spinal fusion (PSF) are not well understood. In this exploratory study, demographics, comorbidities, hospital length of stay (LOS), and discharge status (DS) of patients treated with MIS vs open PSF are analyzed.

METHODS: All patients with an inpatient elective ICD-10 procedure code for PSF, posterior approach, from 10/2015 to 6/2017 were identified in the Premier database. Patients with an ICD-10 code for percutaneous or endoscopic surgery, or with a hospital charge specific to MIS-only surgical devices were categorized as “MIS” patients. All others were categorized as “Open”. Patient demographics (age, gender, marital status, race, payer), hospital characteristics and patient comorbidities (Elixhauser Index) were identified at time of surgery, along procedural information (APR-DRG and MS-DRG) and payer type. Generalized linear models were built to analyze length of stay, percent home discharge and total cost of care for patients with uncomplicated surgery (DRG 460 - APR-DRG 304) in open vs MIS PSF.

RESULTS: CONCLUSIONS: Patients undergoing MIS were similar to open-surgery patients except for obesity, which predominated in open surgeries. Whereas costs for MIS were higher than with open PSF, MIS was associated with statistically shorter LOS and a greater discharged home status vs Open surgery.