Work intensity in sacroiliac joint fusion and lumbar microdiscectomy

• Published in: ClinicoEconomics and outcomes research 2016-07, Vol.2016 (Issue 1), p.367-376
• Main Authors: Frank C, Kondrashov D, Meyer SC, Dix G, Lorio M, Kovalsky D, Cher D
• Format: Article
• Language: English
• Subjects: labor time; reimbursement; Relative value units; spine surgery
• ISSN: 1178-6981; 1178-6981

Clay Frank,1 Dimitriy Kondrashov,2 S Craig Meyer,3 Gary Dix,4 Morgan Lorio,5 Don Kovalsky,6 Daniel Cher7 1Integrated Spine Care, Wawautosa, WI, 2St Mary's Spine Center, San Francisco, CA, 3Columbia Orthopedic Group, Columbia, MO, 4Maryland Brain Spine and Pain, Annapolis, MD, 5Neurospine Solutions, Bristol, TN, 6Orthopaedic Center of Southern Illinois, Mt Vernon, IL, 7SI-BONE, Inc., San Jose, CA, USA Background: The evidence base supporting minimally invasive sacroiliac (SI) joint fusion (SIJF) surgery is increasing. The work relative value units (RVUs) associated with minimally invasive SIJF are seemingly low. To date, only one published study describes the relative work intensity associated with minimally invasive SIJF. No study has compared work intensity vs other commonly performed spine surgery procedures.Methods: Charts of 192 patients at five sites who underwent either minimally invasive SIJF (American Medical Association [AMA] CPT® code 27279) or lumbar microdiscectomy (AMA CPT® code 63030) were reviewed. Abstracted were preoperative times associated with diagnosis and patient care, intraoperative parameters including operating room (OR) in/out times and procedure start/stop times, and postoperative care requirements. Additionally, using a visual analog scale, surgeons estimated the intensity of intraoperative care, including mental, temporal, and physical demands and effort and frustration. Work was defined as operative time multiplied by task intensity.Results: Patients who underwent minimally invasive SIJF were more likely female. Mean procedure times were lower in SIJF by about 27.8 minutes (P