Background The increasing prevalence of obesity has raised concerns about its impact on
surgical outcomes and healthcare costs. This study evaluates the influence of Body Mass
Index (BMI) on intraoperative costs and operative times during open Transforaminal Lumbar
Interbody Fusion (TLIF) procedures using a Time-Driven Activity-Based Costing (TDABC)
approach. Methods A retrospective analysis was conducted on 279 patients who underwent
TLIF between 2019 and 2022. Patients were categorized into five BMI cohorts: healthy …

Objective Spine surgeons are often unaware of drivers of cost variation for anterior cervical
discectomy and fusion (ACDF). We used time-driven activity-based costing to assess the
relationship between body mass index (BMI), total cost, and operating room (OR) times for
ACDFs. Methods Total cost was divided into direct and indirect costs. Individual costs were
obtained by direct observation, electronic medical records, and through querying multiple
departments. Timestamps for all involved personnel and material resources were …