Introduction: Increasing health care costs internationally have provoked hundreds of studies evaluating cost effectiveness of medical care as it relates to outcomes. Such studies serve as guidelines to practicing medicine but in no way relinquish the need for individualizing surgical treatment plans for our craniofacial patients. Over the past ten years we have extensively studied the clinical outcomes for patients in our craniofacial center that have undergone surgical treatment with spring assisted surgery (SAS) and have seen the excellent results. We therefore evaluated the perioperative data and costs of SAS and Cranial Vault Remodeling (CVR) to see if less extensive surgery translates to an economic difference. Methods and Materials: A retrospective chart review was conducted on the patients undergoing surgical treatment for sagittal synostosis from 2004-2006. The patients were placed into two groups: those treated with pi-plasty and those treated with spring assisted surgery. The inclusion criteria consisted of patients treated by our craniofacial team for non-syndromic sagittal synostosis, chart availability and complete economic details accessible. Hospital charges were collected for medicine, laboratory studies, operative charges, hospital stay, materials, and radiography pertaining to the surgery. The clinical data was obtained for age, length of operation, intensive care stay, hospital stay, blood loss, and the amount of blood transfused. Statistical analysis was performed using the standard t test. Results: A total of 46 patients underwent treatment for non-syndromic sagittal synostosis in the specified time period of whom 36 met inclusion criteria (21 spring assisted surgery and 15 pi-plasty). The mean cost of SAS was SEK 60185 (Euro 6629.17) and SEK 85739 (Euro 9443.86) for traditional pi-plasty resulting in a 30% reduction in overall perioperative cost in the SAS group. A 63% reduction was seen in the laboratory fees for the SAS group. Greater than 30% reduction was seen in the SAS group for the ward, operating room, and materials. The charges for blood transfusion, the intensive care, radiology and medication were also decreased in the SAS group (5-20%). The clinical data showed greater than 70% reduction in blood loss and transfusion amounts (71-83%), with greater than 30% reduction in intensive care stay, hospital stay and operative time (34-36%). The overall cost reduction with the SAS was statistically significant. Conclusions: The results of this study reveal a significant decrease in cost for patients undergoing spring assisted cranioplasty for sagittal synostosis as compared to pi-plasty surgery.
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