Two research articles published addressing cost and morbidity associated with fusion procedures


Paradigm Spine has announced the recent publication of two focal clinical research articles addressing both the costs and morbidity associated with fusion procedures performed in the treatment of spinal stenosis, and separately its comparative effectiveness relative to the company’s coflex interlaminar stabilisation device and procedure.

In the recently-released publication titled “Comparative Cost Effectiveness of coflex Interlaminar Stabilisation Versus Instrumented Posterolateral Fusion for the Treatment of Lumbar Stenosis” published in the March 2014 edition of the Journal of Clinicoeconomics and Outcomes Research, researchers suggest that the coflex interlaminar stabilisation device and procedure is better utilised from a comparative effectiveness perspective for the treatment of lumbar spinal stenosis, when compared to instrumented spinal fusion, with savings measured over a five-year time table estimated to be approximately US$11,700 per surgical case.


In a separate publication titled “Perioperative Outcomes, Complications, and Costs Associated with Lumbar Spinal Fusion in Older Patients with Spinal Stenosis and Spondylolisthesis” published in the June 2014 edition of the Journal of Neurosurgery Spine, researchers highlight the incidence of patients undergoing lumbar decompression and spinal fusion for the treatment of spinal stenosis and spondylolisthesis, with an emphasis on the rate of complications, cost, and readmission rates for patients receiving these treatments. The significant amount of both revision surgery rates, as well readmissions for complications of these decompression and fusion procedures are analysed and discussed for a dataset comprised of Medicare patients.


In considering the importance of both recent publications, Marc R Viscogliosi, chairman and chief executive officer of Paradigm Spine, states, “Both publications highlight the common use of spinal fusion after decompression of spinal stenosis, and unfortunately, display the high costs and revision rates associated with spinal fusion in this older age group. We are pleased to see the coflex interlaminar stabilisation procedure being performed more cost-effectively and with significant cost savings compared to spinal fusion in this Medicare age group. Controlling costs and improving outcomes with less morbidity using minimally invasive techniques has to be a better alternative for patients. This comparative effectiveness study highlights the information payers and patients have been waiting for.”


From the surgeon’s perspective, Hallett Mathews, chief medical officer of Paradigm Spine notes the importance of the data to assist surgeons with difficult decisions regarding patient treatment selection and the avoidance of costly mistakes. Mathews states, “Fusion has been the mainstay of stabilisation for decades now, and these studies, along with the landmark studies published by Davis, et al in Spine, August 2013 and Davis, et al in the Journal of Neurosurgery, May 2013, prove to us that a less morbid, minimally invasive form of stabilisation can occur after a decompression for the treatment of moderate to severe lumbar spinal stenosis without the need for rigid segmental stabilisation with a fusion. Maintaining motion and not having to wait for arthrodesis has to be better for this patient group.”