268 9-Year Cost Effectiveness Analysis of Local Drilled Morselized Bone Autograft in Minimally Invasive Transforaminal Lumbar Interbody Fusion

INTRODUCTION: There is a heavy economic burden of spine surgery in the United States due to several factors, including direct healthcare costs, as well as bone graft associated costs, including cellular-based allograft, recombinant human-Bone Morphogenic Protein (rh-BMP) and demineralized bone matrix (DBM). Literature is scarce regarding the cost-savings from the utilization of local drilled morselized bone autograft (DMBA). Autograft has consistently provided high fusion rates. METHODS: A retrospective analysis was conducted for patients who underwent MIS-TLIF procedures by a single surgeon from 2016 to May 2024. The cost-related data of 550 patients who underwent MIS-TLIF were reviewed and analyzed. The cost savings analysis was calculated by assessing the expense associated with allograft bone and quantifying the volume of autograft bone utilized, resulting in a reduction in cellular allograft expenditure. The cellular allograft utilized at our institution was Trinity cellular allograft. RESULTS: The average cost of Trinity cellular allograft was $448 per cc. There was a total of 550 cases that utilized DMBA with a total of 695 levels. A total of 5541cc of autograft was harvested with an average of 8.46cc/level. There was an estimated cost savings of $2,488,951.50 over a 9-year period. The mean direct cost savings per patient was $4,624.15. CONCLUSIONS: The consistent use of DMBA in MIS-TLIF procedures can result in significant bone graft-related cost savings and high fusion rates.