Cost-effectiveness of Corrective Fusion Surgeries for Adult Spinal Deformities A Comparison by Operative Method

被引：5

作者：

Arima, Hideyuki ^{[1
]}

Hasegawa, Tomohiko ^{[1
]}

Yamato, Yu ^{[1
,2
]}

Kato, Masashi ^{[3
]}

Yoshida, Go ^{[1
]}

Banno, Tomohiro ^{[1
]}

Oe, Shin ^{[1
,2
]}

Mihara, Yuki ^{[1
]}

Ushirozako, Hiroki ^{[1
]}

Yamada, Tomohiro ^{[1
]}

Watanabe, Yuh ^{[1
]}

Ide, Koichiro ^{[1
]}

Nakai, Keiichi ^{[1
]}

Kurosu, Kenta ^{[1
]}

Matsuyama, Yukihiro ^{[1
]}

机构：

[1] Hamamatsu Univ Sch Med, Dept Orthoped Surg, Hamamatsu, Shizuoka, Japan

[2] Hamamatsu Univ Sch Med, Div Geriatr Musculoskeletal Hlth, Hamamatsu, Shizuoka, Japan

[3] Hamamatsu Univ Hosp, Div Med Profess, Hamamatsu, Shizuoka, Japan

来源：

SPINE | 2021年 / 46卷 / 18期

关键词：

three-column osteotomy; adult spinal deformity; corrective fusion surgery; cost effectiveness; grade II osteotomy; incremental cost-effectiveness ratio; lateral lumbar interbody fusion; medical expense; quality-adjusted life year; spinal instrumentation; GASTROESOPHAGEAL-REFLUX DISEASE; SCOLIOSIS-RESEARCH-SOCIETY-22 PATIENT QUESTIONNAIRE; SURGICAL-TREATMENT; IDIOPATHIC SCOLIOSIS; INSTRUMENT; RELIABILITY; VALIDATION; CONSTRUCTS; OSTEOTOMY; FIXATION;

D O I：

10.1097/BRS.0000000000004004

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design. Retrospective cohort study. Objective. The aim of this study was to summarize the cost-effectiveness of surgical treatment for adult spinal deformity (ASD) according to the operative method over 2 years postoperatively. Summary of Background Data. Extensive corrective fusion surgery for ASD requires numerous expensive implants, greatly contributing toward the national medical expenses. Previous national studies reported high complication rates in spinal surgeries using instrumentation. However, the cost-effectiveness of such procedures has not been scrutinized. Methods. In total, 173 ASD patients (151 women; mean age 69.1 years) who underwent corrective fusion between 2010 and 2017 were included. Cost-effectiveness was evaluated according to the cost of obtaining 1 quality-adjusted life year (QALY). Patients were divided into three groups: the "corrective fusion surgery using multiple Grade 2 osteotomy'' (Grade-2) group, three-column osteotomy group (three-column), and lateral lumbar interbody fusion (LLIF) group. Results. The average medical cost for the initial surgery was USD 72,240, and that during the 2 years after the initial surgery was USD 76,294. The medical expenses for the initial surgery and those over the 2 years were higher in the LLIF group. The cumulative improvement in QALY over the 2 years did not significantly differ among the groups (0.13, 0.15, and 0.18 in the Grade-2, three-column, and LLIF groups, respectively). Cost/QALY 2 years after the surgery was USD 509,370, 518,406, and 463,798 in the Grade-2, three-column, and LLIF groups, respectively. Conclusion. We summarized the medical costs and cost-effectiveness of three different surgical methods for ASD in patients with different backgrounds over 2 years postoperatively. The medical expense for the initial surgery was highest in the LLIF group, and the cumulative improvement in QALY over the 2 years tended to be higher in the LLIF group, but the difference was not significant; the overall cost-effectiveness was lowest in the LLIF group.

引用

页码：1249 / 1257

页数：9

共 36 条

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