European Spine Journal

, Volume 26, Issue 5, pp 1438–1446 | Cite as

Health-care costs of conservative management of spine fractures in trauma patients

  • Efe Levent Aras
  • Cody Bunger
  • Ebbe Stender Hansen
  • Rikke Søgaard
Original Article


Background and purpose

There is a lack of evidence on the broad health-care costs of treating spine trauma patients without neurological deficits conservatively. The aim of the present study was to estimate the primary and secondary health-care sector costs associated with conservative treatment of spine fractures as well as their determinants.


Patients were identified between 1999 and 2008 in the hospital’s administrative system based on relevant diagnostic codes. Inclusion criteria were: (1) spine fractures (C1–L5); (2) age >18; and (3) conservative treatment. Exclusion criteria were: (1) neurological involvement and (2) fractures secondary to osteoporosis/malignancy. Health-care utilization and costs were retrieved from national administrative databases covering the entire health-care sector.


201 cervical, 150 thoracic, and 140 lumbar fracture patients were included in the study. The total health cost was estimated at €18,919 (16,199; 21,756), €8571 (6062; 11,733), €5526 (3473; 7465) for cervical, thoracic, and lumbar regions, respectively. Hospital admissions accounted for the vast majority of costs while primary health care accounted for less than 3 % and prescription medication for less than 2 %. The determinants of costs included fracture site (p < 0.001) and concomitant lower limb injuries (p = 0.009).


Spinal fractures, even mild ones, appear to incur substantial health-care utilization and costs. Health-care costs in conjunction with cervical fractures are more than two-fold of those affiliated with thoracic and lumbar fractures. Among the concomitant injuries, lower limb injuries exert a substantial influence over health-care costs.


Spine fractures Conservative treatment Health-care utilization Health-care costs 



This study was funded by the Danish Strategic Research Council as part of the CESpine project (Grant 2142-08-0017). We gratefully acknowledge the assistance of Filipe Cortes Figueiredo, Lisbon Faculty of Medicine, University of Lisbon, Portugal and Stanislaus Argeny, Medical University of Vienna for data recruitment and organization during their research stay in Denmark. The authors express their appreciation to Linda Nygaard for help in editing.

Compliance with ethical standards

Conflict of interest

None of the authors has any potential conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Efe Levent Aras
    • 1
  • Cody Bunger
    • 2
  • Ebbe Stender Hansen
    • 2
  • Rikke Søgaard
    • 3
    • 4
  1. 1.Aarhus University Hospital Orthopedic Spinal Research LaboratoryAarhusDenmark
  2. 2.Department of Orthopedic SurgeryAarhus University HospitalAarhusDenmark
  3. 3.Department of Public HealthAarhus UniversityAarhusDenmark
  4. 4.Department of Clinical MedicineAarhus UniversityAarhusDenmark

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