Ogura Y, Gum JL, Hostin RA, et al. - A retrospective economic analysis of a prospective, multicenter database was conducted to compare the 2-year cost-effectiveness of surgical treatment for adult spinal deformity (ASD) between the posterior-only approach and combined anterior-posterior (AP) approach. Researchers distinguished and compared patients undergoing five or more level fusions through a posterior-only or AP approach from a prospective, multicenter surgical database of ASD. They ascertained quality-adjusted life years (QALYs) gained applying baseline, 1-year, and 2-year postoperative Short Form 6D. They estimated cost from actual, direct hospital costs including any subsequent readmission or revision. Cost/QALY gained was applied to ascertain cost-effectiveness. For the surgical treatment, 2-year cost-effectiveness through posterior-only and AP approaches were assessed. Both for the index surgery and at 2-year follow-up, the posterior-only approach was found to be less expensive. At 2-years, the QALY gained was similar between the two approaches. Therefore, posterior-only method was more cost-effective than the AP method under the study parameters. Nevertheless, at 2-year follow-up, both approaches were not cost-effective.