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14,130 results
  • Refining Risk-Adjustment for Bundled Payment Models in Cervical Fusions - An Analysis of Medicare Beneficiaries. [Journal Article]
  • SJSpine J 2019 Jun 18
  • Malik AT, Phillips FM, … Khan SN
  • CONCLUSIONS: The current cervical fusion bundled payment model fails to employ a robust risk adjustment of prices resulting in the large amount of cost-variation seen within 90-day reimbursements. Under the proposed DRG-based risk-adjustment model, providers would be reimbursed the same amount for cervical fusions regardless of the surgical approach (posterior vs. anterior), the extent of fusion, use of adjunct procedures (decompressions) and cause/indication of surgery (fracture vs. degenerative pathology), despite each of these factors having different resource utilization and associated reimbursements. Our findings suggest that defining payments based on DRG codes only is an imperfect way of employing bundled payments for spinal fusions and will only end up creating major financial disincentives and barriers to access of care in the healthcare system.
  • An Analysis of the Cost-Effectiveness of Spinal Versus General Anesthesia for Lumbar Spine Surgery in Various Hospital Settings. [Journal Article]
  • GSGlobal Spine J 2019; 9(4):368-374
  • Morris MT, Morris J, … Joseph V
  • CONCLUSIONS: We conclude that use of spinal anesthesia for lumbar laminectomy leads to less operating room, postanesthesia care unit, and anesthesia times, lower levels of postoperative pain, and no increased rate of other complications compared with general anesthesia at an academic institution as compared to a private practice setting. Spinal anesthesia is 9.93% less expensive than general anesthesia, indicating substantial cost-saving potential. With no sacrifice of patient outcomes and the added benefit of less pain and recovery time, Spinal anesthesia represents a more cost-effective alternative to general anesthesia in lumbar spine surgery in the academic hospital setting.
  • Bony decompression vs duraplasty for Chiari I malformation: does the eternal dilemma matter? [Journal Article]
  • CNChilds Nerv Syst 2019 Jun 18
  • Massimi L, Frassanito P, … Caldarelli M
  • CONCLUSIONS: PFBD and PFBDD are different techniques that are indicated for different types of patients. In children, PFBD has been demonstrated to represent the best choice, although some patients may require a more aggressive treatment. Therefore, the success in the management of CIM, with or without syringomyelia, depends on the correct indication to surgery and on a patient-tailored choice rather than on the surgical technique.
  • Cervical Laminectomy With or Without Lateral Mass Instrumentation: A Comparison of Outcomes. [Journal Article]
  • CSClin Spine Surg 2019 Jun 14
  • Kim BS, Dhillon RS
  • CONCLUSIONS: In carefully selected patients with normal preoperative cervical sagittal alignment, stand-alone cervical laminectomy may offer acceptably low rates of postoperative kyphosis. In patients with preoperative loss of cervical lordosis and/or kyphosis, posterior fusion is recommended to reduce the risk of progression to postoperative kyphotic deformity, bearing in mind that radiologic evidence of kyphosis may not necessarily correlate with poorer clinical outcomes. Furthermore, the specific risks associated with posterior fusion (instrumentation failure, pseudarthrosis, infection, C5 nerve root palsy, and vertebral artery injury) need to be considered and weighed up against potential benefits.
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