205. Impact of single-position on patient outcomes and cost in minimally invasive adult spinal deformity surgery

• Published in: The spine journal 2023-09, Vol.23 (9), p.S105-S106
• Main Authors: Passias, Peter, Dave, Pooja, Das, Ankita, Roberts, Timothy, Lorentz, Nathan, Galetta, Matthew, Lebovic, Jordan, Mir, Jamshaid, Tretiakov, Peter, Schoenfeld, Andrew, Janjua, Muhammad, Macagno, Angel, Onafowokan, Oluwatobi
• Format: Article
• Language: English
• ISSN: 1529-9430; 1878-1632
• DOI: 10.1016/j.spinee.2023.06.013

Compared to repositioning patients for pedicle screw placement after lateral interbody fusion, single-position spine surgery can improve surgical efficiency, reduce operative times, and reduce operative costs. To assess surgical outcomes and cost of single position thoracolumbar adult spinal deformity surgery. Retrospective cohort. ASD MIS. HRQL, Cost, Cost per QALY. Operative minimally invasive ASD patients (coronal Cobb angle≥20°, SVA≥50mm, PT≥25°, and/or thoracic kyphosis>60°) >18yrs with complete baseline (BL) and perioperative radiographic/HRQL data were included. Patients were stratified based on approach: single position (SP) and flipped (FL) groups.  Total costs were calculated from average Medicare DRG reimbursement. Complications, comorbidities (CC), major complications, and comorbidities (MCC) were assessed according to CMS.gov manual definitions. Means comparison, multivariable logistic regressions and ANCOVA were utilized to assess differences in outcomes between SP and F groups. A total of 230 patients met inclusion criteria (60.5yrs, 76%F, BMI: 30.1kg/m2, CCI: 1.8), with 131 patients in the single position (SP) group and 69 patients in the flipped (FL) group. While gender composition and CCI were similar between single position and flipped patients, single position patients were significantly older (63.9±10.9 vs 56.6±10.2, p