Improving Complex Pediatric and Adult Spine Care While Embracing the Value Equation

Rajiv K. Sethi, Vijay Yanamadala, Suken A. Shah, Nicholas D. Fletcher, John Flynn, Virginie Lafage, Frank Schwab, Michael Heffernan, Marinus DeKleuver, Lisa Mcleod, Jean Christophe Leveque, Michael Vitale

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Introduction: Value in health care is defined as the quotient of outcomes to cost. Both pediatric and adult spinal deformity surgeries are among the most expensive procedures offered today. With high variability in both outcomes and costs in spine surgery today, surgeons will be expected to consider long-term cost effectiveness when comparing treatment options. Methods: We summarize various methods by which value can be increased in complex spine surgery, both through the improvement of outcomes and the reduction of cost. These methods center around standardization, team-based and collaborative approaches, rigorous outcomes tracking through dashboards and registries, and continuous process improvement. Results: This manuscript reviews the expert opinion of leading spine specialists on the improvement of safety, quality and improvement of value of pediatric and adult spinal surgery. Conclusion: Without surgeon leadership in this arena, suboptimal solutions may result from the isolated intervention of regulatory bodies or payer groups. The cooperative development of standardized, team-based approaches in complex spine surgery will lead to the high-quality, high-value care for patients.

Original languageEnglish (US)
Pages (from-to)228-235
Number of pages8
JournalSpine deformity
Issue number2
StatePublished - Mar 2019
Externally publishedYes


  • Quality
  • Safety
  • Spine surgery
  • Teams
  • Value

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


Dive into the research topics of 'Improving Complex Pediatric and Adult Spine Care While Embracing the Value Equation'. Together they form a unique fingerprint.

Cite this