The cost of spinal fusion surgery—and how to save money

Back pain is a common and serious condition, with nearly 40% of U.S. adults and more than 619 million people worldwide experiencing it at some point in their lifetime. As a result, some experts estimate that total healthcare costs for dealing with back pain exceed $100 billion a year, while other research suggests that workers lose around 83 million days annually because of the issue—and a decrease in overall income compared to those without back pain.

This is somewhat ironic considering that jobs are a major contributor to back pain: One 2015 study found that 21% of U.S. workers with some kind of low back pain reported being told by a health professional that their condition was probably work-related.

Back pain falls into two categories: acute and chronic. Acute back pain is typically the result of an activity, illness, or injury, and while it often occurs suddenly, it’s usually curable within several days or weeks. Chronic back pain, on the other hand, is gradual and persistent, and it affects some 16 million U.S. adults, or around 8% of the population. Lower back pain, such as sciatica, is a more common issue than upper back pain in the neck and shoulders, and both occur more frequently in older adults.

One long-term solution for back pain many patients consider is spinal fusion surgery. This procedure can be incredibly expensive, which is why, thanks to increasing cases of back pain, employers have seen their musculoskeletal (MSK) costs skyrocket in recent years. Below, we’ll outline what this surgery entails, and how you can drive down spend while still ensuring your employees have the coverage and care they need to combat back pain.

What is spinal fusion surgery?

A spinal fusion fuses together, or connects, two or more vertebrae in the spine to reinforce stability and remove pain, numbness, or weakness as a result of certain movements. Because it’s an invasive surgery, a doctor will want to first pinpoint the source of the patient’s discomfort (via imaging and lab tests) to confirm it’s located in the backbone and best treated with surgery before recommending the patient to a neuro or orthopedic surgeon.

Typically, spinal fusion surgery is used to address the following conditions if other treatments, such as therapy, medication, and lifestyle changes, are ineffective:

During spinal fusion surgery, patients are put under anesthesia for a few hours. The surgeon will use a bone graft (bone material that’s donated or synthetic, or taken from other parts of the body) to secure the fusion and promote bone growth, which will keep the fusion intact long-term and prevent any future erosion or pain. They might also insert a plate, screw, or rod to hold the spine together.

Doctors will take different approaches to spinal fusion surgery depending on where the pain or issue is located, and how severe it is. They may make incisions through the back, front, or side of the body, and doing so could require open surgery (a single large incision that can lead to a longer recovery) or something less invasive (such as laparoscopic, or a series of small incisions that tend to heal faster and cause less pain).

Post-surgery, patients may be asked to wear a brace temporarily for protection, avoid certain activities, or attend physical therapy. Recovery can take several weeks to several months, and follow-up surgery might be required to further treat the problem.

Spinal fusion surgery can significantly improve patients’ quality of life, but the risks associated with one are much like any other surgery—while rare, these risks can include lifestyle limitations, infection, nerve pain, and paralysis.

How much does spinal fusion surgery cost?

It’s hard to say exactly how much a spinal fusion costs in the U.S. (which is part of a bigger problem).

Some cost estimates for spine surgery in the United States range between $50,000 and $150,000. A cost analysis of single-level lumbar fusions in the U.S. between 2008 and 2012 found that patients shelled out up to $73,727, or around $23,000 on average. A  2022 report on spinal fusion surgery costs in the most populous U.S. cities puts the price as low as $48,000 and as high as $86,000—proving that where you’re located could have just as much influence on what you pay as the type and extensiveness of surgery or care you receive.

The cost of spinal fusion surgery depends on the complexity of the patient’s condition, as well as the tests, procedures, and accommodations they receive before, during, and after the surgery. The above cost analysis, for example, estimates that supplies (e.g., titanium implants and surgical instruments) consist of nearly 44% of the total cost, services make up around 38%, and room care and pharmacy make up another 14% and 4% respectively. This doesn’t, however, take into account X-rays, MRIs, or other diagnostic tools and post-operative care.

The bottom line: Not only are spinal fusions quite expensive, but the cost of spinal fusion surgery is highly variable, making it hard for self-funded employers to plan for these types of procedures in their healthcare budgets.

How Carrum can help

When you and your employees need to cover tens of thousands of dollars in surgery fees, it’s easy for everyone to be overwhelmed. A value-based centers of excellence (COE) program like Carrum Health can help.

Carrum connects members with surgeons and centers of excellence facilities that prioritize value-based care—discouraging unnecessarily invasive or overbearing treatment and reducing complications—and thus can provide high-quality support and better health outcomes at a much lower cost.

In short, companies save money and employees get the care they need without a huge financial burden hanging over their heads.

All members who have been recommended to get spinal fusion surgery will also receive an assessment from a surgeon at one of Carrum’s centers of excellence to see if surgery is actually needed before moving forward—many times, these individuals are able to avoid risky, cumbersome decisions through physical therapy and other avenues. Finally, Carrum’s bundled payments mean that all of the costs associated with a spinal fusion from start to finish are included in one pre-negotiated, upfront price.

Spinal fusion surgery can be a game-changer for those struggling with back pain, but the steep price turns off many from getting the proper treatment. With thoughtful approach and investment, companies can flip the script, ensuring their teams can work—and live—comfortably.

Read about Joe’s spinal fusion success story with Carrum.

The information contained on this page is for informational purposes only. No material is intended to be a substitute for professional medical advice, diagnosis, or treatment.