Abstract
Lumbar fusion is the treatment of choice when neurological function is threatened by spinal instability due to trauma, tumor, infection, or congenital anomalies. The benefits of this procedure are much less certain, however, when lumbar fusion is applied to nonurgent conditions such as chronic back pain without neurologic findings. For this large cohort of patients, high and variable charges, high complication rates, and escalating utilization rate across the United States – coupled with uncertain benefits – have provoked increased scrutiny from purchasers and the provider community alike. The current state is not only costly for purchasers and sometimes dangerous for patients, but it is harmful to the credibility of those providers working to improve the safety, appropriateness, reliability, effectiveness, and affordability of lumbar surgical techniques.
In this chapter we will describe efforts over the last 14 years to improve our approach to lumbar fusion and to ensure that this procedure remains a credible, valuable, and sustainable alternative for those patients likely to receive benefit.
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Friedman, A.S., Mecklenburg, R.S. (2020). The Bree Collaborative Bundle for Lumbar Fusion: Evolution of a Community Standard for Quality. In: Sethi, R., Wright, A., Vitale, M. (eds) Value-Based Approaches to Spine Care . Springer, Cham. https://doi.org/10.1007/978-3-030-31946-5_3
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DOI: https://doi.org/10.1007/978-3-030-31946-5_3
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