Spine being guided by orthopedic and neurosurgical hands.

Is Your Surgeon's Specialty Impacting Your Spinal Fusion Outcome?

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"New research reveals how the surgeon's specialization—orthopedic versus neurological—can significantly influence costs, length of stay, and readmission rates after posterior lumbar fusion (PLF)."

Undergoing spinal fusion can feel like navigating a complex maze, especially when it comes to understanding the factors that influence your recovery and costs. With bundled payments becoming more common, it's increasingly important to identify what drives variations in outcomes and expenses. Posterior lumbar fusion (PLF), a frequently performed procedure often handled by different surgical specialties, offers a perfect case study.

A groundbreaking study delved into the impact of the surgeon's specialty on PLF outcomes. Researchers investigated whether having an orthopedic surgeon versus a neurological surgeon perform your PLF could affect key factors like readmission rates, length of stay, hospitalization costs, and the need for unplanned care.

This article breaks down the study's findings, offering clear insights into how surgical service may indeed play a significant role in your PLF journey. Armed with this knowledge, you'll be better prepared to discuss your options with your healthcare team and make informed decisions about your treatment.

Ortho vs. Neuro: Key Differences in PLF Outcomes

Spine being guided by orthopedic and neurosurgical hands.

The study, encompassing a review of 3,225 patients who underwent PLF at a single institution between 2006 and 2016, revealed some noteworthy differences between orthopedic and neurological surgeons:

Patients treated by neurological surgeons experienced:

Longer hospital stays, both with and without considering outliers.
Higher likelihood of discharge to the ICU.
Increased odds of readmission within both 30 and 90 days post-surgery.
Significantly higher direct costs associated with the procedure.

Specifically, the neurological surgeon cohort had a significantly higher proportion of ASA three or four patients (44.32% vs. 30.62%, p<.0001), indicating potentially more complex cases. The direct costs were also substantially higher in the neurological surgeon cohort, averaging $4,342 more than the orthopedic cohort (95% CI: $2,970 - $5,713; p<.0001).

The Bigger Picture: Implications for Your Care

This research underscores that the surgical service involved—orthopedic versus neurological—can contribute to variations in resource utilization, costs, and postoperative outcomes for PLF patients. It's not about one specialty being “better” than the other, but rather understanding the potential differences and how they might impact your individual care.

So, what does this mean for you? If you're considering PLF, it's crucial to have an open discussion with your surgeon about their experience, typical patient outcomes, and cost considerations. Don't hesitate to ask about factors that might influence your length of stay, potential for readmission, and overall expenses.

Ultimately, this study serves as a reminder that informed decision-making is key to navigating your spinal fusion journey. By understanding the potential impact of surgical service and engaging in proactive conversations with your healthcare provider, you can work together to optimize your outcomes and ensure a smoother recovery.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

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Everything You Need To Know

1

What key differences did the study reveal between orthopedic and neurological surgeons in Posterior Lumbar Fusion (PLF) outcomes?

The research highlights that the choice between an orthopedic surgeon and a neurological surgeon for Posterior Lumbar Fusion (PLF) can lead to different outcomes. While both specialties perform the procedure, the study found that patients treated by neurological surgeons experienced longer hospital stays, a higher chance of ICU discharge, increased readmission rates, and higher direct costs. These differences highlight that the surgical service involved, be it orthopedic or neurological, plays a role in PLF outcomes.

2

Why is Posterior Lumbar Fusion (PLF) a significant topic in this research?

Posterior Lumbar Fusion (PLF) is a frequently performed surgical procedure. It is a perfect case study for understanding how different surgical approaches, such as those of orthopedic surgeons versus neurological surgeons, impact patient outcomes and healthcare costs. Given the increasing use of bundled payments, understanding these variations is crucial for optimizing patient care and resource allocation.

3

What factors might explain the different outcomes observed between orthopedic and neurological surgeons performing Posterior Lumbar Fusion (PLF)?

The difference in outcomes between orthopedic and neurological surgeons performing Posterior Lumbar Fusion (PLF) can be attributed to several factors. The study noted that patients treated by neurological surgeons had a higher proportion of ASA three or four patients, indicating more complex cases. This could explain the longer hospital stays, higher ICU discharge rates, and increased readmission rates. Furthermore, the study revealed significantly higher direct costs associated with PLF performed by neurological surgeons, emphasizing the financial implications of these differences.

4

How can the findings about orthopedic versus neurological surgeons affect my care when considering Posterior Lumbar Fusion (PLF)?

When considering Posterior Lumbar Fusion (PLF), it's essential to discuss the surgeon's specialty with your healthcare team. The research indicates that the choice between an orthopedic surgeon and a neurological surgeon can influence your length of stay, the likelihood of being readmitted, and the overall costs of the procedure. Understanding these potential differences allows you to have an informed conversation with your doctor and make decisions aligned with your preferences and needs.

5

What are the broader implications of the research findings regarding orthopedic and neurological surgeons performing Posterior Lumbar Fusion (PLF)?

The implications of this research are significant because it highlights that the surgical service involved in Posterior Lumbar Fusion (PLF) can impact patient outcomes. It provides insights into how different specialties, orthopedic versus neurological surgeons, may influence factors like hospital stays, readmission rates, and costs. This information is crucial for patients seeking PLF, helping them understand the potential impact of their surgeon's specialization on their care journey.