Geographical variation in outcomes and costs following spinal fusion for adolescent idiopathic scoliosis

Abstract Purpose The aim of this study was to evaluate regional variations in the management, complications and total cost of admission for adolescent idiopathic scoliosis treated by elective, posterior spinal surgery (≥4 levels). methods The Kids’ Inpatient Database year 2012 was queried and adolescent patients (age 10-17 years old) with AIS undergoing elective, PSF (≥4 levels) were selected. The primary outcome was regional variations for intraoperative and postoperative complications, LOS, and total cost of admission after elective PSF intervention. Results In our cohort of 3,759 adolescent patients identified, 704 (18.7%) patients were treated in the Northeast, 917 (24.4%) in the Midwest, 1,329 (35.4%) in the South, and 809 (21.5%) in the West (Northeast: n=704; Midwest: n=917; South: n=1,329; West: n=809). The Northeast had the greatest complication rate, followed by the Midwest, South, and West region cohorts (Northeast: 27.7% vs. Midwest: 24.5% vs. South: 23.0% vs. West: 17.2%, p conclusions Our study suggests that there may be regional variations in healthcare resource utilization in AIS patients undergoing multi-level posterior spinal fusions. Further study is warranted to determine the specific factors contributing to disparities in regional outcomes.