Retrospective cost analysis of cervical laminectomy and fusion versus cervical laminoplasty in the treatment of cervical spondylotic myelopathy

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Fig. 1
Breakdown of physician cost calculation (Medicare reimbursement formula).
Download figure
Open in new tab
Download powerpoint
Fig. 2
Distribution of costs per procedure.

Table 1

Demographics of cohorts

Table 2

Total cost by cohort

All P-values correspond to data in USD.
↵* Values are given as the mean ± standard deviation.
↵† Reported as a ratio of [mean value for procedure]/[mean value for alternative procedure] (eg, [CLP average charge]/[CLF average charge]).
↵‡ Includes surgeon, anesthesia, and neuromonitoring fees.
↵§ Sum of hospital cost and physician cost.
↵‖ Statistical significance.

Table 3

C3-7 subanalysis

All P-values correspond to data in USD.
↵* Values are given as the mean ± standard deviation.
↵† Reported as a ratio of [mean value for procedure]/[mean value for alternative procedure] (eg, [CLP average charge]/[CLF average charge]).
↵‡ Includes surgeon, anesthesia, and neuromonitoring fees.
↵§ Sum of hospital cost and physician cost.
↵‖ Statistical significance.

Table 4

Operating room–related costs

	CLP (n = 55) ($)^*	Percentage of total expenses^†	CLF (n = 26) ($)^*	Percentage of total expenses^†	P
Anesthesia	302 ± 135	3.8	361 ± 185	1.6	.1
Cell saver	579 ± 738	7.2	770 ± 765	3.5	.3
Graft	1145 ± 685	14.3	104 ± 334	0.5	<.01^‡
Imaging	290 ± 336	3.6	699 ± 466	3.1	<.01^‡
Implant	75 ± 558	0.9	11,357 ± 7894	51.0	<.01^‡
NM	1030 ± 524	12.8	1419 ± 853	6.4	.04^‡
OR	1836 ± 870	22.9	2820 ± 1554	12.7	<.01^‡
ORI	752 ± 315	9.4	1186 ± 727	5.3	<.01^‡
ORM	1114 ± 1339	13.9	2565 ± 6854	11.5	.3
Procedure	38 ± 109	0.5	81 ± 189	0.4	.3
Transfusion	51 ± 232	0.6	62 ± 181	0.3	.8
RR	767 ± 318	9.6	794 ± 493	3.6	.7
Pathology	41 ± 19	0.5	48 ± 45	0.2	.3
Total	8019	100.0	22,265	100.0	–

Abbreviations: NM, neuromonitoring; OR, operating room; ORI, operating room instruments; ORM, operating room materials; RR, Recovery Room.
↵* Values are given as the mean ± standard deviation.
↵† Values are given as percentage of total expenses.
↵‡ Statistical significance.

Table 5

Perioperative-related costs

	CLP (n = 55) ($)^*	Percentage of total expenses^†	CLF (n = 26) ($)^*	Percentage of total expenses^†	P
Housekeeping	1686 ± 1299	22.3	2692 ± 1643	20.2	<.01^‡
Laboratory	246 ± 215	3.3	1360 ± 5206	10.2	.3
Materials	297 ± 765	3.9	860 ± 887	6.4	<.01^‡
Medications	189 ± 157	2.5	504 ± 546	3.8	<.01^‡
Pain management	106 ± 184	1.4	160 ± 277	1.2	.3
PT	287 ± 221	3.8	630 ± 561	4.7	<.01^‡
Room	4738 ± 2434	62.8	7148 ± 3730	53.5	<.01^‡
Total	7549	100	13,352	100	–

Table 6

Total cost by procedure, within insurance type

Non-Medicare patients	CLP (n = 31)	CLF (n = 15)	P
Hospital cost ($)^*	14,762 ± 5093	33,336 ± 9720	<.01^‡
Hospital charge^*^†	0.62 ± 0.40	1.48 ± 0.95	<.01^‡
Hospital payment received^*^†	0.74 ± 0.54	1.54 ± 1.13	<.01^‡
Medicare patients	CLP (n = 24)	CLF (n = 11)	P

Hospital cost ($)^*	16,284 ± 4700	30,474 ± 10,870	<.01^‡
Hospital charge*^†	0.58 ± 0.37	1.39 ± 0.88	.01^‡
Hospital payment received^*^†	0.52 ± 0.28	1.08 ± 0.59	<.01^‡

All P-values correspond to data in USD.
↵* Values are given as the mean and standard deviation.
↵† Reported as a ratio of [average value for insurance type]/[average value for alternative insurance type] (eg, [CLP average charge-non-Medicare patients]/[CLP average charge-Medicare patients]).
↵‡ Statistical significance.

Table 7

Total cost by insurance type, within procedure

CLP	Non-Medicare (n = 31)	Medicare (n = 24)	P
Hospital cost ($)^*	14,762 ± 5093	16,284 ± 4700	.3
Hospital charge*^†	0.94 ± 0.81	1.07 ± 1.23	.5
Hospital payment received^*^†	1.18 ± 0.93	0.85 ± 1.07	.1
Marginal value^*	7.07 ± 0.94 (gain)	0.14 ± 1.06 (loss)	.04^‡
CLF	Non-Medicare (n = 15)	Medicare (n = 11)	P

Hospital cost ($)^*	33,336 ± 9720	30,474 ± 10,870	.3
Hospital charge*^†	1.18 ± 0.81	0.85 ± 1.23	.4
Hospital payment received*^†	1.71 ± 1.97	0.58 ± 0.51	.1
Marginal value^*	1.98 ± 3.6 (gain)	0.50 ± 0.28 (loss)	.04^‡

All P-values correspond to data in USD.
↵* Values are given as the mean and standard deviation.
↵† Reported as a ratio of [average value for insurance type]/[average value for alternative insurance type] (eg, [CLP average charge-non-Medicare patients]/[CLP average charge-Medicare patients]).
↵‡ Statistical significance.