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Value Considerations in the Surgical Management of Spondylolisthesis

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Spondylolisthesis

Abstract

Value-based health care is an increasingly important priority in our health care economy and has particular relevance to the field of spine surgery. Value includes a consideration of both quality and cost—the value of a health care intervention is assessed by whether it provides an incremental benefit in outcome to justify an incremental increase in cost. To achieve optimal value, variability of care between practitioners should be minimized.

Defining the place of surgery for spondylolisthesis in a value-based healthcare economy includes an analysis of whether surgical care is cost-effective compared with alternative treatments and determining the specific surgical strategies that are most effective. The medical and surgical management of spondylolisthesis is characterized by significant variability. Current questions and controversies in the operative management of spondylolisthesis include the need for decompression, fusion, instrumentation, and circumferential fusion. An evidence-based approach to care is key to reducing variability and optimizing value in health care. The purpose of this chapter is to describe the role of value considerations in spine-related conditions and to provide a summary of the evidence on value-based care in the management of degenerative and isthmic spondylolisthesis.

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Disclosure

Presentation of this work was made possible by R25MD006832 from the National Institute on Minority Health and Health Disparities. The views expressed do not necessarily reflect the official policies of the DHHS.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, UC San Francisco, 500 Parnassus Ave, San Francisco, CA, 94143, USA

    Melissa Esparza B.A. & Sigurd H. Berven M.D.

Authors
  1. Melissa Esparza B.A.
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  2. Sigurd H. Berven M.D.
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Corresponding author

Correspondence to Sigurd H. Berven M.D. .

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Editors and Affiliations

  1. Assistant Professor of Orthopedic Surgery, Albert Einstein College of Medicine, New York, New York, USA

    Adam L. Wollowick

  2. Associate Professor of Orthopedic Surgery, Albert Einstein College of Medicine, Department of Orthopedic Surgery, Montefiore Medical Center, Bronx, New York, USA

    Vishal Sarwahi

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Esparza, M., Berven, S.H. (2015). Value Considerations in the Surgical Management of Spondylolisthesis. In: Wollowick, A., Sarwahi, V. (eds) Spondylolisthesis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7575-1_28

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  • DOI: https://doi.org/10.1007/978-1-4899-7575-1_28

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7574-4

  • Online ISBN: 978-1-4899-7575-1

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