Lumbar spine disorders constitute a substantial clinical and economic challenge for healthcare systems worldwide. Their high prevalence, chronic course, and diverse treatment pathways result in significant direct medical costs as well as indirect costs related to disability, loss of productivity, and long-term care. As multiple surgical and non-surgical interventions are available for common lumbar conditions, variation in treatment selection has important economic implications. Cost-effectiveness and cost-utility analyses provide structured approaches to compare the value of competing interventions by relating costs to patient-centered outcomes such as pain relief, functional improvement, and quality-adjusted life years. This chapter examines the economic burden associated with lumbar spine disorders and reviews evidence on the cost-effectiveness of key lumbar interventions, including surgery, minimally invasive techniques, interventional pain procedures, and perioperative strategies. Emphasis is placed on interpreting economic evidence in the context of clinical effectiveness, healthcare system constraints, and value-based spine care.