Surgical fusion volumes have spiked over the last few decades, with the incidence of lumbar fusion increasing by nearly 240% between 2000 and 2009. This is troubling because fusions can increase complication risks over decompression procedures, an alternative for some conditions, and raise costs without improving care quality. In fact, spinal fusion costs per case increased from $24,676 to $81,960 over the same 2000-2009 period.