Processing and handling cost of single-use versus traditional instrumentation for 1 level lumbar fusions

Matthew S. Galetta*, Srikanth N. Divi, Mark A. Shapses, Joseph B. Hartman, Kristen J. Nicholson, Dhruv K.C. Goyal, Taolin Fang, John J. Mangan, Ian David Kaye, Mark F. Kurd, Barrett I. Woods, Kris E. Radcliff, Jeffrey A. Rihn, David Greg Anderson, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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 Costresuable 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.

Original languageEnglish (US)
Pages (from-to)E39-E44
JournalClinical spine surgery
Issue number1
StatePublished - Feb 2021


  • 1 level fusion
  • Cost
  • Disposable
  • Instruments
  • Reusable instrumentation
  • Single level
  • Single-use instrumentation
  • Sterile
  • Sterilized
  • Trays

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology


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