38. Long-term cost difference in surgical vs nonsurgical treatment of lumbar spondylolisthesis

Over the past two decades, there has been a notable increase in lumbar fusion procedures. In 2011, spinal fusion surgeries in the United States incurred the highest overall costs among all surgical procedures. Extensive evidence, including multicenter randomized-controlled trials, supports the use of surgery for lumbar spondylolisthesis and stenosis. However, the growing aggregate cost of these procedures has drawn the attention of healthcare payers, policymakers, and physicians. Prior research has indicated that long-term non-operative treatments before fusion are cost-inefficient, and surgical treatment for lumbar spondylolisthesis is a cost-effective strategy. Nevertheless, there is a lack of data regarding the long-term cost difference between patients treated with lumbar spondylolisthesis surgery and those without surgery when examining a comprehensive national database.