In 2011, there were 146,100 hospital discharges for spondylolisthesis reported in the HCUP NIS database. The average length of stay for these patients was 4 days, and tended to trend slightly upwards with age. The mean charges for hospital discharges with a diagnosis of spondylolisthesis was $93,900, which was unexpectedly higher than all other deformity codes evaluated and statistically similar to costs associated with hospital discharges for patients with complications of spine surgery diagnosis.
Among the much smaller sample of patients with a diagnosis of spondylolisthesis who were first seen in the emergency department (ED) and transferred to inpatient status, the average length of stay was slightly longer (5.2 days), but with lower average charges of $46,800. The proportion of patients with a spondylolisthesis diagnosis hospitalized after being seen in the ED who had a surgical procedure was much lower than those reported in the inpatient database. (Reference Table 3.4.1 PDF CSV; Table 3.4.2 PDF CSV; and Table 3.5.1 PDF CSV)
Nearly two-thirds (61%) of inpatients with a spondylolisthesis diagnosis were discharged from the hospital to home, although the proportion was lower when hospitalized after visiting the ED. Another 15% to 18% went home with home health care. One in five (21%) were transferred to a skilled nursing facility. Age is a major factor in discharge status, with 44% of patients age 75 years and older discharged to skill nursing/intermediate care. (Reference Table 3.3.1 PDF CSV and Table 3.3.2 PDF CSV)
Three out of four patients (75%) hospitalized with a diagnosis of spondylolisthesis were treated with a spinal fusion. About one-half were treated with instrumentation and decompression. Patients with spondylolisthesis often received more than one procedure in their stay. The overall costs for treatment of spondylolisthesis would be much higher than simply the hospitalization cost. The direct cost of nonsurgical treatments, such as medications, therapy, injections, braces, etc., and the indirect costs associated with treatment of this condition such as lost wages, non-productive time away from work, costs of medical care providers, are not included in these databases although they may be quite substantial. (Reference Table 3.5.1 PDF CSV)