Direct medical costs of traumatic thoracolumbar spine fractures.
BACKGROUND
The costs and cost-effectiveness of treatment of thoracolumbar fractures are poorly known.


METHODS
We estimated the costs of hospital care and outpatient visits for patients with traumatic thoracolumbar spine fractures.


RESULTS
Stable fractures without neurological deficits were treated nonoperatively and the costs were EUR 5,100. Unstable fractures without neurological deficits were treated either nonoperatively, with an average of 29 hospitalization days and average cost of EUR 12,500 (86% of which represented hospitalization costs), or operatively with 24 hospitalization days and average cost of EUR 19,700 (48% of which represented hospitalization costs and 42% surgery costs). Unstable fractures with neurological deficits were usually operated (average costs EUR 31,900).


CONCLUSIONS
For all patients, the costs of hospitalization days were the main cost driver. Although the length of stay for patients with unstable fractures and without neurological deficit who were treated operatively was shorter than for patients treated nonoperatively, the total costs were higher due to the additional costs of surgery. Surgical treatment must therefore be shown to give a better outcome in order to outweigh the costs. Future research should focus on the cost-effectiveness of operative and nonoperative treatment of patients with unstable vertebral fractures who have no neurological deficits, and take indirect costs and quality of life into account.
van der Roer
Nicole
N
Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands. N.vanderroer@vumc.nl
de Bruyne
Martine C
MC
Bakker
Fred C
FC
van Tulder
Maurits W
MW
Boers
Maarten
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D005592:Fracture Fixation / Q000191:economics / Q000379:methods; D005593:Fracture Fixation, Internal / Q000191:economics / Q000379:methods; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016103:Spinal Fractures / Q000191:economics* / Q000209:etiology / Q000601:surgery / Q000628:therapy; D013904:Thoracic Vertebrae / Q000293:injuries