association between surgical costs and outcomes. Although higher cost did not guarantee an ideal outcome, high cost patients generally experienced superior patient reported outcomes and realignment at 2-years. Thus, isolating cost reduction as a public health priority may compromise outcomes in ASD patients.

METHODS: MarketScan database were queried using the ICD-9/10 and CPT 4th edition, from 2003 to 2019. We included patients ≥ 18 of age who underwent spine fusions with at least 2 years follow-up. Outcomes were repeat fusions or new fusions, length of stay (LOS), discharge disposition, hospital re-admissions, outpatient services, and medication refills for up to 24 months following the index procedure.RESULTS: Of 183,620 patients who underwent spine fusions during the study years, 5046 (2.75%) were identified to have CAN used for the fusions. Exact matching was successful for 4861/5046 (96%) in the CAN group. CAN had no effect on LOS, home discharge, or complications at index hospitalization and 30-days post discharge. However, CAN was associated with a $7667 difference in median payments ($60501 vs $52834, p < .0001). CAN was associated with lower rates of repeat fusions at 6-months (3% vs. 4%), 12 months (2% vs. 3%) and 24 months (5% vs. 6%) following the index procedure, p < 0.05. Patients who underwent CAN had lower payments at 6 months