Cost effectiveness of subaxial fusion-lateral mass screws versus transarticular facet screws

As health care reform continues to evolve, demonstrating the cost effectiveness of spinal fusion procedures will be of critical value. Posterior subaxial cervical fusion with lateral mass screw and rod instrumentation is a wellestablished fixation technique. Subaxial transarticular facet fixation is a lesser known fusion technique that has been shown to be biomechanically equivalent to lateral mass screws for short constructs. Although there has not been a widespread adoption of transarticular facet screws, the screws potentially represent a cost-effective alternative to lateral mass rod and screw constructs. In this review, the authors describe an institutional experience with the use of lateral mass screws and provide a theoretical cost comparison with the use of transarticular facet screws.