Comparing Costs of Spinal Surgery for Two Types of Scoliosis

In this study researchers at the University of Utah compared children who had spinal surgery for two types of scoliosis (curvature of the spine). The first type of scoliosis is called neuromuscular scoliosis (NMS). NMS often accompanies other conditions such as muscular dystrophy, cerebral palsy, and spina bifida. The second type is idiopathic scoliosis (IS). Idiopathic scoliosis occurs in otherwise able-bodied children, especially girls. The cause is unknown.

Treatment with surgery to keep the curves from getting worse is more common with NMS but may be needed with IS as well. A special database of information collected from hospitals in 2000 was used in this study. It’s called the Healthcare Cost and Utilization Project Kids Inpatient Database or HUCP KID.

By studying the discharge records of children with both types of scoliosis the authors report the following findings:

  • Children with NMS stayed in the hospital longer after spinal surgery.
  • Hospital and medical costs for the NMS group were much higher ($20,000 more for the NMS patient compared to the IS patient).
  • Children with NMS had twice as many other diagnoses (e.g., failure to thrive, reflux) at the time of hospital admission compared to the IS group
  • Children with NMS had more problems during their hospital stay such as pneumonia, urinary tract infections, and delayed wound healing.
  • The NMS group were more likely to need home health care or transfer to another health care facility at the time of discharge.

    The authors conclude children having spinal surgery for NMS have longer and more costly hospitalizations compared to children with IS. Children with NMS are also at greater risk for complications after spinal surgery. Further study is needed to find ways to reduce risk factors for children with NMS undergoing this type of surgery.