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A Comparison of Peri-operative Costs and Outcomes in Patients With and Without Workers’ Compensation Claims Treated with MIS or Open TLIF.

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A Comparison of Peri-operative Costs and Outcomes in Patients With and Without Workers’ Compensation Claims Treated with MIS or Open TLIF.

Spine (Phila Pa 1976). 2012 Apr 5;

Authors: Pelton MA, Phillips FM, Singh K

Abstract
Study Design. Non-randomized, non- blinded prospective review.Objective. To analyze intraoperative, immediate post-operative and financial outcomes in worker’s compensation and non-worker’s compensation patients undergoing either an open or MIS TLIF.Summary of Background Data. Few studies have analyzed outcomes in a worker’s compensation (WC) population of MIS (Minimally Invasive Surgery) TLIFs (Transforaminal Lumbar Interbody Fusions.Methods. 66 consecutive patients undergoing a single-level TLIF (open/MIS) were analyzed (33 open, 33 MIS). Twenty-four total workers compensation patients were identified (11 MIS, 13 open). Patients in either cohort (MIS/Open) were matched according to insurance status (WC) and medical co-morbidities (Charleston disability index). Every patient in this study had a diagnosis of either degenerative disc disease or spondylolisthesis and stenosis. Operative time (minutes), Length of stay (LOS, days), estimated blood loss (EBL, cc), anesthesia time (minutes), VAS scale scores, and hospital cost/payment amount were assessed (MIS/open and Work-Comp versus Non-Work Comp).Results. There were no statistically significant differences between MIS WC and non-WC TLIFs with respect to surgical time, LOS, EBL, VAS scores and Anesthesia time. There were no statistically significant differences between Open WC and non-WC TLIF patients in all of the same above-mentioned parameters. There were significant differences between MIS (WC and non-WC) and Open (WC and non-WC) TLIFs in clinical outcomes. There were statistically significant differences in total costs amounts between WC MIS TLIF and WC Open TLIF ($28,060 vs $33,862 respectively; p = 0.0311) and Non-WC MIS TLIF versus Non-WC Open TLIF groups ($29,429 vs $32,998 respectively; p = 0.0001).Conclusion. Contrary to popular belief immediate outcomes and hospitalizations between non-WC and WC populations did not differ regardless of surgical technique (MIS/open). Differences appeared in improved outcomes with an MIS TLIF versus an Open TLIF even in a WC environment. MIS TLIF WC and non-WC patient hospital costs were lower than their open TLIF counterparts.

PMID: 22487713 [PubMed – as supplied by publisher]

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