Table 5.
Cost Variability for the Treatment of Lower Back Pain With Positive Discogram at L4-L5 and L5-S1 (Scenario 4).
| Surgeon Characteristics | Two-level ALIF With Posterior Fixation (%) | Two-Level PLIF/TLIF (%) | No Surgery (%) | Average Cost per Surgeon | P Value |
|---|---|---|---|---|---|
| Region | .256 | ||||
| Midwest | 12 (14) | 16 (19) | 58 (67) | $7499 | |
| Northeast | 15 (19) | 23 (29) | 41 (52) | $11 066 | |
| Southeast | 9 (12) | 21 (28) | 46 (61) | $9052 | |
| Southwest | 7 (26) | 6 (22) | 14 (52) | $11 130 | |
| West | 9 (21) | 6 (14) | 28 (65) | $8081 | |
| Specialty | .075 | ||||
| Neurological surgery | 10 (12) | 31 (36) | 44 (52) | $11 041 | |
| Orthopedic | 42 (19) | 41 (18) | 143 (63) | $8481 | |
| surgery | |||||
| Fellowship training | .260 | ||||
| Yes | 47 (19) | 49 (20) | 155 (62) | $8827 | |
| No | 5 (8) | 23 (38) | 32 (53) | $10 658 | |
| Practice type | .110 | ||||
| Academic | 16 (19) | 10 (12) | 60 (70) | $7007 | |
| Hybrid | 12 (20) | 14 (24) | 33 (56) | $10 161 | |
| Private | 24 (14) | 48 (29) | 94 (57) | $9958 | |
| Surgeries per year | .572 | ||||
| 0-100 | 2 (6) | 9 (29) | 20 (65) | $8105 | |
| 101-150 | 13 (23) | 9 (16) | 34 (61) | $9097 | |
| 151-200 | 9 (13) | 20 (30) | 38 (57) | $9929 | |
| 201-250 | 13 (23) | 12 (21) | 32 (56) | $10 133 | |
| 251-300 | 10 (20) | 12 (24) | 27 (55) | $10 350 | |
| >300 | 5 (10) | 10 (20) | 36 (71) | $6752 | |
| Practice length in years | .247 | ||||
| <5 | 6 (17) | 4 (11) | 26 (72) | $6434 | |
| 5-10 | 10 (17) | 9 (16) | 39 (67) | $7570 | |
| 10-15 | 10 (22) | 13 (28) | 23 (50) | $11 518 | |
| 15-20 | 8 (13) | 12 (20) | 41 (67) | $7544 | |
| >20 | 18 (20) | 15 (16) | 58 (64) | $8385 | |
| Discogram use | <.001* | ||||
| Never | 5 (5) | 10 (10) | 81 (84) | $3587 | |
| Rarely | 19 (15) | 22 (18) | 82 (67) | $7686 | |
| Sometimes | 17 (29) | 23 (39) | 19 (32) | $15 491 | |
| Often | 11 (33) | 17 (52) | 5 (15) | $19 519 |
Abbreviations: ALIF, anterior lumbar interbody fusion; PLIF, posterior lumbar interbody fusion; TLIF, transforaminal lumbar interbody fusion.
*statistically significant at P < .01