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


  • Nicholas D Thomas Florida State University College of Medicine
  • 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
  • Benjamin Childs William Beaumont Army Medical Center/Texas Tech University Health Science Center Department of Orthopaedic Surgery and Rehabilitation



business, cost, value-based practice, fusion


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


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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.

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