Business Articles in Spine Journals Focus Primarily on Fusion and Identify Factors Impacting Surgery and Costs

Authors

  • Nicholas D Thomas Florida State University College of Medicine https://orcid.org/0000-0002-1043-5150
  • Taha Hmissa Florida State University College of Medicine
  • Chris Bacak William Beaumont Army Medical Center/Texas Tech University Health Science Center Department of Orthopaedic Surgery and Rehabilitation
  • Franklin Powlan William Beaumont Army Medical Center/Texas Tech University Health Science Center Department of Orthopaedic Surgery and Rehabilitation https://orcid.org/0000-0001-8417-8065
  • Benjamin Childs William Beaumont Army Medical Center/Texas Tech University Health Science Center Department of Orthopaedic Surgery and Rehabilitation

DOI:

https://doi.org/10.55576/job.v3i3.38

Keywords:

business, cost, value-based practice, fusion

Abstract

Objectives: Review and analyze business related spine articles in top general orthopaedic journals and compare to top subspecialty spine journals.

Design: Literature Review

Intervention: General orthopaedic vs subspecialty spine journals.

Outcome Measure: Publication type, subject

Results: From 2017-2021, there were a total of 16 spine related business articles across JBJS, B&JJ, CORR, and JAAOS. That accounts for 0.2% of total publications (16/7011) and 6.3% of the business publications (16/253) in these journals over this 5-year span. Spine surgery business publications accounted for a wide range of editorial space, ranging from 2.9% of B&JJ business publications to 8.5% of JAAOS publications.

Across the four subspecialty journals of interest, there were 158 business related articles published for the 5-year study period. Spine accounted for approximately 53% of these publications. Business articles represented 2.2% of all articles published in subspecialty spine journals from 2017-2021. The distribution of business topics represented in the subspecialty journals was notable, with the most addressed topic being cost analysis. Comparatively, 75% of spine related business articles in general orthopaedic journals articles focused on value-based practice. Advanced age, insurance status, gender, ethnicity and obesity, were important drivers of cost.

Conclusions: Subspecialty spine journals tend to publish a higher number and percentage of business articles related spine surgery compared to general orthopaedics journal. This demonstrates increasing interest in the economics of surgical procedures and identifying ways to safely improve cost efficiency, and combat health disparities in spine surgery.

Level of Evidence: IV; Review

Keywords: Orthopaedic business, spine, cost, value-based practice, finance, fusion

References

Thomas N, Sandler A, Fernandez I, et al. Orthopaedic Business is the Focus of 3.4% of Articles in Top General Orthopaedic Journals. J Orthop Bus. 2022;2(1):10-18. doi:10.55576/job.v2i1.11

SJR - Journal Search. Accessed March 6, 2023. https://www.scimagojr.com/journalsearch.php?q=spine

Arima H, Hasegawa T, Yamato Y, et al. Cost-effectiveness of Corrective Fusion Surgeries for Adult Spinal Deformities : A Comparison by Operative Method. Spine. 2021;46(18):1249-1257. doi:10.1097/BRS.0000000000004004

Schadler P, Derman P, Lee L, et al. Does the Addition of Either a Lateral or Posterior Interbody Device to Posterior Instrumented Lumbar Fusion Decrease Cost Over a 6-Year Period? Glob Spine J. 2018;8(5):471-477. doi:10.1177/2192568217738766

Droeghaag R, Hermans SMM, Caelers IJMH, Evers SMAA, van Hemert WLW, van Santbrink H. Cost-effectiveness of open transforaminal lumbar interbody fusion (OTLIF) versus minimally invasive transforaminal lumbar interbody fusion (MITLIF): a systematic review and meta-analysis. Spine J Off J North Am Spine Soc. 2021;21(6):945-954. doi:10.1016/j.spinee.2021.01.018

Jazini E, Gum JL, Glassman SD, et al. Cost-effectiveness of circumferential fusion for lumbar spondylolisthesis: propensity-matched comparison of transforaminal lumbar interbody fusion with anterior-posterior fusion. Spine J. 2018;18(11):1969-1973. doi:10.1016/j.spinee.2018.03.019

Saifi C, Cazzulino A, Laratta J, et al. Utilization and Economic Impact of Posterolateral Fusion and Posterior/Transforaminal Lumbar Interbody Fusion Surgeries in the United States. Glob Spine J. 2019;9(2):185-190. doi:10.1177/2192568218790557

Passias PG, Brown AE, Alas H, et al. A cost benefit analysis of increasing surgical technology in lumbar spine fusion. Spine J. 2021;21(2):193-201. doi:10.1016/j.spinee.2020.10.012

Paranjape CS, Gentry RD, Regan CM. Cost-Effectiveness of Bariatric Surgery Prior to Posterior Lumbar Decompression and Fusion in an Obese Population with Degenerative Spondylolisthesis. Spine. 2021;46(14):950. doi:10.1097/BRS.0000000000003940

Chotai S, Parker SL, Sielatycki JA, et al. Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease. Eur Spine J. 2017;26(4):1236-1245. doi:10.1007/s00586-016-4835-3

Khan A, Meyers JE, Blasio P, et al. Evaluation of Benefit and Cost Utility of Immediate Postanesthesia Care Unit Radiographs to Predict Airway Compromise After Anterior Cervical Discectomy and Fusion. Spine. 2021;46(10):671-677. doi:10.1097/BRS.0000000000003896

Kim JS, Dowdell J, Cheung ZB, et al. The Seven-Year Cost-Effectiveness of Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty: A Markov Analysis. Spine. 2018;43(22):1543. doi:10.1097/BRS.0000000000002665

McAnany SJ, Merrill RK, Overley SC, Kim JS, Brochin RL, Qureshi SA. Investigating the 7-Year Cost-Effectiveness of Single-Level Cervical Disc Replacement Compared to Anterior Cervical Discectomy and Fusion. Glob Spine J. 2018;8(1):32-39. doi:10.1177/2192568217726283

Overley SC, McAnany SJ, Brochin RL, Kim JS, Merrill RK, Qureshi SA. The 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion or cervical disc replacement: a Markov analysis. Spine J. 2018;18(1):63-71. doi:10.1016/j.spinee.2017.06.036

Merrill RK, McAnany SJ, Albert TJ, Qureshi SA, other. M abstract: W conducted a cost effectiveness analysis using 7 years follow up data from a two level FI study of patients who underwent cervical disc replacement or anterior cervical discectomy and fusion. B procedures were cost-effective but we cannot conclude that one is more cost effective than the. Is Two-level Cervical Disc Replacement More Cost-effective Than Anterior Cervical Discectomy and Fusion at 7 Years? Spine. 2018;43(9):610-616. doi:10.1097/BRS.0000000000002380

Neifert SN, Lamb CD, Gal JS, et al. Later Surgical Start Time Is Associated With Longer Length of Stay and Higher Cost in Cervical Spine Surgery. Spine. 2020;45(17):1171. doi:10.1097/BRS.0000000000003516

Kelley BV, Hsiue PP, Upfill-Brown AM, et al. Utilization trends and outcomes of computer-assisted navigation in spine fusion in the United States. Spine J. 2021;21(8):1246-1255. doi:10.1016/j.spinee.2021.03.029

Beckerman D, Esparza M, Lee SI, et al. Cost Analysis of Single-Level Lumbar Fusions. Glob Spine J. 2020;10(1):39-46. doi:10.1177/2192568219853251

Johnston SS, Fortin SP, Pracyk JB, Tommaselli GA, Elangovanraaj N, Chen BP. Economic and clinical outcomes of spinal fusion surgeries with skin closure through skin staples plus waterproof wound dressings versus 2-octyl cyanoacrylate plus polymer mesh tape. Spine J. 2021;21(1):45-54. doi:10.1016/j.spinee.2020.08.017

Buttermann G, Hollmann S, Arpino JM, Ferko N. Value of single-level circumferential fusion: a 10-year prospective outcomes and cost-effectiveness analysis comparing posterior facet versus pedicle screw fixation. Eur Spine J. 2020;29(2):360-373. doi:10.1007/s00586-019-06165-0

Stubig T, Ahmed M, Ghasemi A, Nasto LA, Grevitt M. Total Disc Replacement Versus Anterior-Posterior Interbody Fusion in the Lumbar Spine and Lumbosacral Junction: A Cost Analysis. Glob Spine J. 2018;8(2):129-136. doi:10.1177/2192568217713009

Culler SD, McGuire KJ, Little KM, et al. Incremental Hospital Cost and Length-of-stay Associated With Treating Adverse Events Among Medicare Beneficiaries Undergoing Cervical Spinal Fusion During Fiscal Year 2013 and 2014. Spine. 2017;42(20):1578-1586. doi:10.1097/BRS.0000000000002268

Malik AT, Phillips FM, Retchin S, et al. Refining risk adjustment for bundled payment models in cervical fusions—an analysis of Medicare beneficiaries. Spine J. 2019;19(10):1706-1713. doi:10.1016/j.spinee.2019.06.009

Martini ML, Baron RB, Gal JS, et al. Comparison of Cost and Perioperative Outcome Profiles for Primary and Revision Posterior Cervical Fusion Procedures. Spine. 2021;46(19):1295. doi:10.1097/BRS.0000000000004019

Myhre SL, Buser Z, Meisel HJ, et al. Trends and Cost of Posterior Cervical Fusions With and Without Recombinant Human Bone Morphogenetic Protein-2 in the US Medicare Population. Glob Spine J. 2017;7(4):334-342. doi:10.1177/2192568217699188

Barton C, Kalakoti P, Bedard NA, Hendrickson NR, Saifi C, Pugely AJ. What Are the Costs of Cervical Radiculopathy Prior to Surgical Treatment? Spine. 2019;44(13):937. doi:10.1097/BRS.0000000000002983

Virk SS, Phillips FM, Moffatt-Bruce SD, Khan SN. What Factors Influence Reimbursement for 1 to 2 Level Anterior Cervical Discectomy and Fusion Procedures? Spine. 2019;44(1):E33. doi:10.1097/BRS.0000000000002766

Bronson WH, Kingery MT, Hutzler L, et al. Lack of Cost Savings for Lumbar Spine Fusions After Bundled Payments for Care Improvement Initiative: A Consequence of Increased Case Complexity. Spine. 2019;44(4):298. doi:10.1097/BRS.0000000000002812

Basques BA, Louie PK, Shifflett GD, et al. Effect of Surgeon Volume on Complications, Length of Stay, and Costs Following Anterior Cervical Fusion. Spine. 2017;42(6):394. doi:10.1097/BRS.0000000000001756

Donnally CJI, Vakharia RM, Rush AJI, et al. Fibromyalgia as a Predictor of Increased Postoperative Complications, Readmission Rates, and Hospital Costs in Patients Undergoing Posterior Lumbar Spine Fusion. Spine. 2019;44(4):E233. doi:10.1097/BRS.0000000000002820

Kalakoti P, Gao Y, Hendrickson NR, Pugely AJ. Preparing for Bundled Payments in Cervical Spine Surgery: Do We Understand the Influence of Patient, Hospital, and Procedural Factors on the Cost and Length of Stay? Spine. 2019;44(5):334. doi:10.1097/BRS.0000000000002825

Shahrestani S, Chen XT, Ballatori AM, et al. Complication Trends and Costs of Surgical Management in 11,086 Osteoporotic Patients Receiving Lumbar Fusion. Spine. 2021;46(21):1478-1484. doi:10.1097/BRS.0000000000004051

Rosenthal NA, Heinrich KH, Chung J, Yu H. Cost and Hospital Resource Utilization of Staphylococcus aureus Infection Post Elective Posterior Instrumented Spinal Fusion Surgeries in U.S. Hospitals: A Retrospective Cohort Study. Spine. 2019;44(9):637-646. doi:10.1097/BRS.0000000000002898

Puvanesarajah V, Hassanzadeh H. The True Cost of a Dural Tear: Medical and Economic Ramifications of Incidental Durotomy During Lumbar Discectomy in Elderly Medicare Beneficiaries. Spine. 2017;42(10):770. doi:10.1097/BRS.0000000000001895

Ament J, Thaci B, Yang Z, et al. Cost-effectiveness of a Bone-anchored Annular Closure Device Versus Conventional Lumbar Discectomy in Treating Lumbar Disc Herniations. Spine. 2019;44(1):5. doi:10.1097/BRS.0000000000002746

Choi KC, Shim HK, Kim JS, et al. Cost-effectiveness of microdiscectomy versus endoscopic discectomy for lumbar disc herniation. Spine J. 2019;19(7):1162-1169. doi:10.1016/j.spinee.2019.02.003

Wang D, Xie W, Cao W, He S, Fan G, Zhang H. A Cost-utility Analysis of Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Lumbar Disc Herniation: Transforaminal: versus: Interlaminar. Spine. 2019;44(8):563. doi:10.1097/BRS.0000000000002901

Mordhorst TR, Jalali A, Nelson R, Brodke DS, Spina N, Spiker WR. Cost analysis of primary single-level lumbar discectomies using the Value Driven Outcomes database in a large academic center. Spine J. 2021;21(8):1309-1317. doi:10.1016/j.spinee.2021.03.017

Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. The cost effectiveness of minimally invasive spine surgery in the treatment of adult degenerative scoliosis: a comparison of transpsoas and open techniques. Spine J. 2019;19(2):339-348. doi:10.1016/j.spinee.2018.05.040

Yagi M, Ames CP, Keefe M, et al. A cost-effectiveness comparisons of adult spinal deformity surgery in the United States and Japan. Eur Spine J. 2018;27(3):678-684. doi:10.1007/s00586-017-5274-5

Jain A, Yeramaneni S, Kebaish KM, et al. Cost–Utility Analysis of rhBMP-2 Use in Adult Spinal Deformity Surgery. Spine. 2020;45(14):1009. doi:10.1097/BRS.0000000000003442

Ames CP, Smith JS, Gum JL, et al. Utilization of Predictive Modeling to Determine Episode of Care Costs and to Accurately Identify Catastrophic Cost Nonwarranty Outlier Patients in Adult Spinal Deformity Surgery: A Step Toward Bundled Payments and Risk Sharing. Spine. 2020;45(5):E252. doi:10.1097/BRS.0000000000003242

Ogura Y, Gum JL, Hostin RA, et al. Cost-effectiveness of surgical treatment of adult spinal deformity: comparison of posterior-only versus anteroposterior approach. Spine J. 2020;20(9):1464-1470. doi:10.1016/j.spinee.2020.03.018

Yamamoto T, Yagi M, Suzuki S, et al. Limited Cost Benefit of Lateral Interbody Fusion for Adult Spinal Deformity Surgery. Spine. 2021;46(1):48. doi:10.1097/BRS.0000000000003703

Beschloss A, Dicindio C, Lombardi J, et al. Marked Increase in Spinal Deformity Surgery Throughout the United States. Spine. 2021;46(20):1402-1408. doi:10.1097/BRS.0000000000004041

Carreon LY, Glassman SD, Lurie J, et al. Cost-effectiveness of Operative versus Nonoperative Treatment of Adult Symptomatic Lumbar Scoliosis an Intent-to-treat Analysis at 5-year Follow-up. Spine. 2019;44(21):1499. doi:10.1097/BRS.0000000000003118

Varshneya K, Azad TD, Pendharkar AV, et al. Adult Spinal Deformity Surgery in Patients With Movement Disorders: A Propensity-matched Analysis of Outcomes and Cost. Spine. 2020;45(5):E288. doi:10.1097/BRS.0000000000003251

Raman T, Nayar SK, Liu S, Skolasky RL, Kebaish KM. Cost-Effectiveness of Primary and Revision Surgery for Adult Spinal Deformity. Spine. 2018;43(11):791. doi:10.1097/BRS.0000000000002481

Brown AE, Alas H, Pierce KE, et al. Obesity negatively affects cost efficiency and outcomes following adult spinal deformity surgery. Spine J. 2020;20(4):512-518. doi:10.1016/j.spinee.2019.12.012

Passias PG, Poorman GW, Bortz CA, et al. Predictors of adverse discharge disposition in adult spinal deformity and associated costs. Spine J. 2018;18(10):1845-1852. doi:10.1016/j.spinee.2018.03.022

Sanders AE, Andras LM, Sousa T, Kissinger C, Cucchiaro G, Skaggs DL. Accelerated Discharge Protocol for Posterior Spinal Fusion Patients With Adolescent Idiopathic Scoliosis Decreases Hospital Postoperative Charges 22%. Spine. 2017;42(2):92. doi:10.1097/BRS.0000000000001666

Kobayashi K, Ando K, Machino M, et al. Trends in Medical Costs for Adolescent Idiopathic Scoliosis Surgery in Japan. Glob Spine J. 2020;10(8):1040-1045. doi:10.1177/2192568219886265

Tannous OO, Banagan KE, Belin EJ, et al. Low-Density Pedicle Screw Constructs for Adolescent Idiopathic Scoliosis: Evaluation of Effectiveness and Cost. Glob Spine J. 2018;8(2):114-120. doi:10.1177/2192568217735507

Harshavardhana NS, Noordeen MHH, Dormans JP. Cost Analysis of Magnet-driven Growing Rods for Early-onset Scoliosis at 5 Years. Spine. 2019;44(1):60. doi:10.1097/BRS.0000000000002738

Ikwuezunma I, Wang K, Margalit A, Sponseller P, Jain A. Cost-utility Analysis Comparing Bracing Versus Observation for Skeletally Immature Patients with Thoracic Scoliosis. Spine. 2021;46(23):1653-1659. doi:10.1097/BRS.0000000000004189

Jacobs K, Dewilde T, Vandoren C, et al. Variability in Hospital Costs of Adult Spinal Deformity Care. Spine. 2020;45(17):1221. doi:10.1097/BRS.0000000000003497

Frankel WC, Navarro SM, Haeberle HS, Ramanathan D, Ramkumar PN. Optimizing the Volume–Value Relationship in Laminectomy: An Evidence-Based Analysis of Outcomes and Economies of Scale. Spine. 2019;44(9):659. doi:10.1097/BRS.0000000000002910

Ziino C, Mertz K, Hu S, Kamal R. Decompression With or Without Fusion for Lumbar Stenosis: A Cost Minimization Analysis. Spine. 2020;45(5):325. doi:10.1097/BRS.0000000000003250

Machado GC, Maher CG, Ferreira PH, et al. Trends, Complications, and Costs for Hospital Admission and Surgery for Lumbar Spinal Stenosis. Spine. 2017;42(22):1737-1743. doi:10.1097/BRS.0000000000002207

Rosas S, Knio ZO, Gowd AK, Luo TD, Emory CL, O’Gara TJ. Cost and Complications of Single-Level Lumbar Decompression in Those Over and Under 75: A Matched Comparison. Spine. 2021;46(1):29. doi:10.1097/BRS.0000000000003686

Aichmair A, Burgstaller JM, Schwenkglenks M, et al. Cost-effectiveness of conservative versus surgical treatment strategies of lumbar spinal stenosis in the Swiss setting: analysis of the prospective multicenter Lumbar Stenosis Outcome Study (LSOS). Eur Spine J. 2017;26(2):501-509. doi:10.1007/s00586-016-4937-y

Alluri R, Kang HP, Bouz G, Wang J, Hah RJ. The True Effect of a Lumbar Dural Tear on Complications and Cost. Spine. 2020;45(3):E155. doi:10.1097/BRS.0000000000003213

Vail D, Azad TD, O’Connell C, Han SS, Veeravagu A, Ratliff JK. Postoperative Opioid Use, Complications, and Costs in Surgical Management of Lumbar Spondylolisthesis. Spine. 2018;43(15):1080-1088. doi:10.1097/BRS.0000000000002509

Goh BC, Striano BM, Lopez WY, et al. Laminoplasty versus laminectomy and fusion for cervical spondylotic myelopathy: a cost analysis. Spine J. 2020;20(11):1770-1775. doi:10.1016/j.spinee.2020.07.012

Cremins M, Vellanky S, McCann G, Mancini M, Sanzari L, Yannopoulos A. Considering healthcare value and associated risk factors with postoperative urinary retention after elective laminectomy. Spine J. 2020;20(5):701-707. doi:10.1016/j.spinee.2020.01.012

Bronheim RS, Caridi JM, Steinberger J, et al. American Society of Anesthesiologists’ Status Association With Cost and Length of Stay in Lumbar Laminectomy and Fusion: Results From an Institutional Database. Spine. 2020;45(5):333. doi:10.1097/BRS.0000000000003257

Morris MT, Morris J, Wallace C, et al. An Analysis of the Cost-Effectiveness of Spinal Versus General Anesthesia for Lumbar Spine Surgery in Various Hospital Settings. Glob Spine J. 2019;9(4):368-374. doi:10.1177/2192568218795867

Herman PM, Anderson ML, Sherman KJ, Balderson BH, Turner JA, Cherkin DC. Cost-Effectiveness of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care among Adults with Chronic Low-Back Pain. Spine. 2017;42(20):1511-1520. doi:10.1097/BRS.0000000000002344

Fritz JM, Kim M, Magel JS, Asche CV. Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial. Spine. 2017;42(5):285. doi:10.1097/BRS.0000000000001729

Olafsson G, Jonsson E, Fritzell P, Hägg O, Borgström F. Cost of low back pain: results from a national register study in Sweden. Eur Spine J. 2018;27(11):2875-2881. doi:10.1007/s00586-018-5742-6

Spears CA, Hodges SE, Kiyani M, et al. Healthcare Resource Utilization and Management of Chronic, Refractory Low Back Pain in the United States. Spine. 2020;45(20):E1333-E1341. doi:10.1097/BRS.0000000000003572

Alvin MD, Mehta V, Halabi HA, Lubelski D, Benzel EC, Mroz TE. Cost-Effectiveness of Cervical Epidural Steroid Injections: A 3-Month Pilot Study. Glob Spine J. 2019;9(2):143-149. doi:10.1177/2192568218764913

Carreon LY, Bratcher KR, Ammous F, Glassman SD. Cost-effectiveness of Lumbar Epidural Steroid Injections. Spine. 2018;43(1):35-40. doi:10.1097/BRS.0000000000000989

Hahne AJ, Ford JJ, Surkitt LD, et al. Individualized Physical Therapy Is Cost-Effective Compared With Guideline-Based Advice for People With Low Back Disorders. Spine. 2017;42(3):E169. doi:10.1097/BRS.0000000000001734

Manchikanti L, Soin A, Mann DP, Bakshi S, Pampati V, Hirsch JA. Comparative Analysis of Utilization of Epidural Procedures in Managing Chronic Pain in the Medicare Population: Pre and Post Affordable Care Act. Spine. 2019;44(3):220. doi:10.1097/BRS.0000000000002785

Soer R, Reneman MF, Mierau JO, et al. Can We Change Health Care Costs in Patients With Complex Back Pain? Spine. 2020;45(20):1443-1450. doi:10.1097/BRS.0000000000003550

Herman PM, Lavelle TA, Sorbero ME, Hurwitz EL, Coulter ID. Are Nonpharmacologic Interventions for Chronic Low Back Pain More Cost Effective than Usual Care? Proof of Concept Results from a Markov Model. Spine. 2019;44(20):1456-1464. doi:10.1097/BRS.0000000000003097

Thomas KA, Cabell A, Hu SS. Relationship between industry royalty and licensing payments and patent authorship among orthopedic spine surgeons. Spine J. 2021;21(4):541-547. doi:10.1016/j.spinee.2020.12.003

Weiner JA, Cook RW, Hashmi S, et al. Factors Associated With Financial Relationships Between Spine Surgeons and Industry. Spine. 2017;42(18):1412-1418. doi:10.1097/BRS.0000000000002121

Makhni MC, Park PJ, Jimenez J, et al. The medicolegal landscape of spine surgery: how do surgeons fare? Spine J. 2018;18(2):209-215. doi:10.1016/j.spinee.2017.06.038

Durand WM, Eltorai AEM, Shantharam G, et al. Medical Malpractice Claims Following Incidental Durotomy Due to Spinal Surgery. Spine. 2018;43(13):940. doi:10.1097/BRS.0000000000002469

Lopez CD, Boddapati V, Lombardi JM, et al. Recent trends in medicare utilization and reimbursement for lumbar spine fusion and discectomy procedures. Spine J. 2020;20(10):1586-1594. doi:10.1016/j.spinee.2020.05.558

Published

2023-07-03

How to Cite

Nicholas D Thomas, Hmissa, T., Bacak, C., Powlan, F., & Childs, B. (2023). Business Articles in Spine Journals Focus Primarily on Fusion and Identify Factors Impacting Surgery and Costs. Journal of Orthopaedic Business, 3(3), 21–42. https://doi.org/10.55576/job.v3i3.38

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