© 2020

Value-Based Approaches to Spine Care

Sustainable Practices in an Era of Over-Utilization

  • Rajiv K. Sethi
  • Anna K. Wright
  • Michael G. Vitale

Table of contents

  1. Front Matter
    Pages i-xi
  2. Stephen L. Ondra
    Pages 1-22
  3. Brook I. Martin, Sohail K. Mirza, Daniel J. Finch
    Pages 23-38
  4. Vijay Yanamadala, Anna K. Wright, Andrew S. Friedman, Reza Yassari, Andrew I. Gitkind, Robert S. Mecklenburg et al.
    Pages 61-77
  5. Michael A. Bohl, Gary S. Kaplan
    Pages 79-96
  6. Jean-Christophe A. Leveque
    Pages 97-115
  7. Sayf S. A. Faraj, Tsjitske M. Haanstra, Anna K. Wright, Marinus De Kleuver, Miranda L. Van Hooff
    Pages 155-170
  8. Richard Menger, Han Jo Kim, Michael G. Vitale
    Pages 171-190
  9. Back Matter
    Pages 191-197

About this book


Beginning with a review of current trends in health care delivery leading to more value-based platforms, this unique and up-to-date book then focuses on how modern spine care is being shaped by the aging population, scientific and technological advancements, and the economic impact of various treatment modalities, providing insight into the seminal efforts surrounding sustainable spine care guideline development. The over-utilization of spine fusion surgery and adult spinal deformity are presented as examples that have led to a decline in the value of care delivered, as well as how a multidisciplinary evaluation by the range of clinicians involved in spine surgery can revise recommendations for management. The benefits and risks of LEAN methodology for streamlining and standardizing spine care approaches are discussed, and the specific approach of the Seattle Spine Team is presented as an example of successful system-wide improvement. Similar changes to outcome measurement, specifically for adult spinal deformity, are described. Last, the future of technology in spine care is presented, including robotics, nanotechnology, 3D printing, and the use of biologics and biomaterials.

Given the broad scope of topics covered in this book, the intended audience includes not only orthopedic and spinal surgeons, neurosurgeons, physiatrists, and medical students, residents and fellows, but also hospital CEOs, CMOs, administrators, health services researchers, and health care policymakers, consultants and strategists.


Adverse event Complex spine surgery Cost efficiency LEAN methodology Lumbar fusion Patient outcome reporting Predictive modeling Prospective outcomes Registry platform Spine care Spine disease Standard work protocol Technology for spine surgery Value-based approach

Editors and affiliations

  • Rajiv K. Sethi
    • 1
  • Anna K. Wright
    • 2
  • Michael G. Vitale
    • 3
  1. 1.Neuroscience InstituteVirginia Mason Medical CenterSeattleUSA
  2. 2.Neuroscience InstituteVirginia Mason Medical CenterSeattleUSA
  3. 3.Columbia UniversityNew YorkUSA

About the editors

Rajiv K. Sethi, MD, Director, Neuroscience Institute, Departments of Orthopedics and Neurosurgery, Virginia Mason Medical Center, Department of Health Sciences, University of Washington, Seattle, WA, USA

Anna K. Wright, PhD, Neuroscience Institute, Virginia Mason Medical Center, Seattle, WA, USA

Michael G. Vitale, MD, MPH, Professor of Pediatric Orthopedic Surgery, Chief of Pediatric Spine and Scoliosis Surgery, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, USA

Bibliographic information

  • Book Title Value-Based Approaches to Spine Care
  • Book Subtitle Sustainable Practices in an Era of Over-Utilization
  • Editors Rajiv K. Sethi
    Anna K. Wright
    Michael G. Vitale
  • DOI
  • Copyright Information Springer Nature Switzerland AG 2020
  • Publisher Name Springer, Cham
  • eBook Packages Medicine Medicine (R0)
  • Softcover ISBN 978-3-030-31945-8
  • eBook ISBN 978-3-030-31946-5
  • Edition Number 1
  • Number of Pages XI, 197
  • Number of Illustrations 10 b/w illustrations, 7 illustrations in colour
  • Topics Orthopedics
  • Buy this book on publisher's site
Industry Sectors
Health & Hospitals