Processing And Handling Cost Of Single-Use Versus Traditional Instrumentation For 1 Level Lumbar Fusions

Study Design: A single center, observational prospective clinical study. Objective: The aim of this study was to compare the instrumentation-related cost and efficiency of single-use instrumentation versus traditional reusable instrument trays. Summary of Background Data: Single-use instrumentation provides the opportunity to reduce costs associated with cleaning and sterilizing instrumentation after surgery. Although previous studies have shown single-use instrumentation is effective in other orthopedic specialties, it is unclear if single-use instrumentation could provide economic advantages in spine surgery. Materials and Methods: A total of 40 (20 reusable instrumentation and 20 single-use instrumentation) lumbar decompression (1-3 level) and fusion (1 level) spine surgeries were collected. Instrument handling, opening, setup, re-stocking, cleaning, sterilization, inspection, packaging, and storage were recorded by direct observation for both reusable and single-use instrumentation. The rate of infection was noted for each group. Results: Mean time of handling instruments by the scrub nurse was 11.6 (+/- 3.9) minutes for reusable instrumentation and 2.1 (+/- 0.5) minutes for single-use instrumentation. Mean cost of handling reusable instruments was estimated to be $8.52 (+/-$2.96) per case, and the average cost to reprocess a single tray by Sterilization Processing Department (SPD) was $58. Thus, the median cost for sterilizing 2 reusable trays per case was $116, resulting in an average total Cost(resuable) of $124.52 (+/-$2.96). Mean cost of handling single-use instrumentation was estimated to be $1.57 ($0.38) per case. Conclusion: Single-use instrumentation provided greater cost savings and reduced time from the opening of instrumentation to use in surgery when compared with reusable instrumentation.