title: A comparison of perioperative charges and outcome between open and mini-open approaches for anterior lumbar discectomy and fusion.
abstract: The objectives of this study were to examine charge data and long-term outcomes of two approaches for anterior lumbar interbody fusion: a mini-open lateral approach (extreme lateral interbody fusion, XLIF) and an open anterior approach (anterior lumbar interbody fusion, ALIF) through retrospective chart review. A total of 202 patients underwent surgery: 87 with ALIF (Open) and 115 with XLIF (Mini-open) procedures, all with transpedicular fixation. Complications occurred in 16.7% of Open, and 8.2% of Mini-open, procedures (p = 0.041). The mean charges ($US) for one-level Mini-open and Open procedures were $91,995 and $102,146, and for two-level procedures were $124,540 and $144,183, respectively. All differences were statistically significant (p < 0.05). This represents a 10% cost-savings, based on charges, for one-level and 13.6% for two-level Mini-open compared to Open procedures. Functional outcomes improved significantly at two years for both cohorts, although the difference between groups was not statistically significant. In conclusion, the Mini-open approach, compared to the Open, resulted in clinical as well as cost benefits with similar long-term outcomes.
authors.affiliation: Western Regional Center for Brain and Spine Surgery, Las Vegas, NV 89109, USA. Neurospinedoc@gmail.com
authors.forename: William D
authors.initials: WD
authors.lastname: Smith
authors.forename: Ginger
authors.initials: G
authors.lastname: Christian
authors.forename: Sherrie
authors.initials: S
authors.lastname: Serrano
authors.forename: Kyle T
authors.initials: KT
authors.lastname: Malone
mesh_terms: D000293:Adolescent; D017586:Diskectomy / Q000191:economics* / Q000401:mortality*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000191:economics / Q000401:mortality; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000191:economics* / Q000401:mortality*; D055009:Spondylosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery