712001 - Cost Analysis of Early Onset Scoliosis Surgeries in the United States After the Introduction of Magnetic Controlled Growing Rods

Thursday, February 27, 2020

1:45 PM – 1:50 PM

Location: 208

Participants should be aware of the following financial/non-financial relationships:

Dylan Morris, DO: I do not have any relevant financial / non-financial relationships with any proprietary interests.

William F. Lavelle, MD: 4-web (Individual(s) Involved: Self, Products/Services: stock): Own small amount of stock <1%; AAOS (Individual(s) Involved: Self, Products/Services: Committee Member): Committee Member; Cardan Robotics/Mobius (Individual(s) Involved: Self, Products/Services: Stock Ownership): Own small amount of stock <1%; Depuy Synthese (Individual(s) Involved: Self, Products/Services: Consulting/Research): Consulting/Research; Empiriacal Spine (Individual(s) Involved: Self, Products/Services: Research Support): Research Support; Innovasis (Individual(s) Involved: Self, Products/Services: Surgeon Advisory Board): Surgeon Advisory Board; ISASS/IJSS (Individual(s) Involved: Self, Products/Services: Editorial Board): ; K2M Stryker Spine (Individual(s) Involved: Self, Products/Services: Research Support): Research Support; Lumbar Spine Research Society (Individual(s) Involved: Self, Products/Services: Committee Member): Committee Member; Medtronic (Individual(s) Involved: Self, Products/Services: Research Support): Research Support; Prosydian (Individual(s) Involved: Self, Products/Services: Surgeon Advisory Board /Stock): Stock ownership <1%; Scoliosis Research Society (SRS) (Individual(s) Involved: Self, Products/Services: Committee Member): Committee Member

Swamy Kurra, MBBS: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Ravi Dhawan: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Prisco J. DeMercurio: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: The frequency of magnetic controlled growing rods (MCGR) use has increased in the United States since 2014. It is used to manage early onset scoliosis (EOS) due to potentially fewer surgical procedures compared to traditional growing rods.

Purpose: The purpose of this study was to investigate if the introductions of MCGRs have any effect on total hospital charges in EOS surgeries in the United States.
Study Design/Setting: The Healthcare Cost and Utilization Project (HCUP) 2016 Kids’ Inpatient Database (KID) was used for EOS surgeries cost analysis. HCUP 2012-year KID data was used as a control group. HCUP KID registry updates inpatients data from over 4000 hospitals (44 states) every 3 years.
Eligible Population: 199 patients: 2012 HCUP KID (n=106); 2016 HCUP KID (n=93)

Methods: Patients with EOS aged between 1 and ≤10 years and who had posterior surgeries were identified by ICD-9-CM (International Classification of Diseases, Clinical Modification) and ICD-10-CM diagnostic and procedure codes from the 2012 and 2016 KID databases, respectively. EOS patients’ demographics, operative variables, length of stay (LOS), and total hospital charges (THC) were analyzed and compared between 2012 and 2016 cohorts. THCs were calculated as per 2018 inflation.
Outcome Measures: Cost analysis of EOS Surgeries in the United States after the introduction of MCGRs.

Results: No statistical difference was shown for mean age (6 years vs. 6.6 years, p=.22); females (69% vs. 66%, p=.36); complications rates (8.5% vs. 7.5%, p=.49); and THCs ($196,237 vs. $213,392, p=.30) between 2012 and 2016 cohorts, respectively. The average LOS days (7 vs. 4, p=.02) and comorbidities (9 vs. 4, p<0.01) were significantly higher in the 2012 cohort. However, significantly higher THCs were noticed in the 2016 cohort for patients who had 3 days LOS ($184804, n=52 vs. $141372, n=18, p<.05), 5 days LOS ($204552, n=83 vs. $136630, n=63, p<.05), 7 days LOS ($206661, n=86 vs. $159816, n=85, p<.05) compared to 2012 cohort, respectively.

Conclusion: The $40,000 increase in 2016 THC for patients with 7 days LOS might be due to MCGRs. The introduction of MCGRs may have significantly increased the THCs for EOS surgeries in the United States. The reason for no difference in THCs between cohorts was due to longer LOS in 2012 cohort.

Presenting Author(s)

Dylan Morris, DO

Spine Fellow
Upstate Medical University Hospital

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

William F. Lavelle, MD

Associate Professor
SUNY-Upstate Medical University

Disclosure: 4-web : Own small amount of stock <1% (Status: Ongoing); AAOS : Committee Member (Status: Ongoing); Cardan Robotics/Mobius : Own small amount of stock <1% (Status: Terminated --- Company sold); Depuy Synthese : Consulting/Research (Status: Ongoing); Empiriacal Spine : Research Support (Status: Ongoing); Innovasis : Surgeon Advisory Board (Status: Ongoing); K2M Stryker Spine : Research Support (Status: Terminated --- Study Concluded); Lumbar Spine Research Society : Committee Member (Status: Ongoing); Medtronic : Research Support (Status: Ongoing); Prosydian : Stock ownership <1% (Status: Ongoing); Scoliosis Research Society (SRS) : Committee Member (Status: Ongoing)
Swamy Kurra, MBBS

Research Fellow
SUNY Upstate Medical University

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Ravi Dhawan

Undergraduate Researcher
SUNY Upstate Medical University

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Prisco J. DeMercurio

Medical Student
SUNY Upstate Medical University

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.