{"title":"单侧双侧内窥镜椎间盘切除术与经皮内窥镜层间椎间盘切除术治疗单侧腰椎间盘突出症的临床疗效和成本效益比较：一项回顾性配对对照研究。","authors":"Yi-Fan Yang, Jun-Cheng Yu, Zhi-Wei Zhu, Ya-Wei Li, Zhen Xiao, Cong-Gang Zhi, Zhong Xie, Yi-Jun Kang, Jian Li, Bin Zhou","doi":"10.1186/s13018-024-05231-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the efficacy and cost-utility of unilateral biportal endoscopy (UBE) versus percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of single-level lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 99 patients who underwent either UBE (n = 33) or PEID (n = 66) between July 2022 and December 2023 at the Second Xiangya Hospital. Patients were matched 1:2 based on age, sex, and surgery level to ensure comparability. Clinical outcomes were assessed using Visual Analog Scale (VAS), European Quality of Life-5 Dimensions (EQ-5D), and Oswestry Disability Index (ODI) scores, with quality-adjusted life years (QALYs) calculated for cost-utility analysis. Hospitalization costs were analyzed, and the incremental cost-utility ratio (ICER) was determined.</p><p><strong>Results: </strong>Both UBE and PEID groups demonstrated significant postoperative improvements in VAS, EQ-5D, and ODI scores (p < 0.05). The operative time, blood loss and nursing cost were significantly higher for UBE compared to PEID (p < 0.05). UBE has higher gained QALY and overall costs, but the differences are not statistically significant (p = 0.643 for QALY, p = 0.327 for costs). The Incremental Cost-Effectiveness Ratio (ICER) for UBE compared to PEID was calculated to be $354.5 per QALY gained, indicating that for each additional QALY gained through UBE, an additional cost of $354.5 is incurred compared to PEID.</p><p><strong>Conclusion: </strong>In our single-center study conducted in China, both the UBE and PEID procedures have demonstrated comparable short-term efficacy in alleviating pain and improving functional ability in patients with single-level LDH. UBE procedure demonstrates greater cost-utility than the PEID procedure in cost-utility analysis, despite its longer operative time, higher nursing costs and greater blood loss.</p>","PeriodicalId":16629,"journal":{"name":"Journal of Orthopaedic Surgery and Research","volume":"19 1","pages":"755"},"PeriodicalIF":2.8000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562584/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of clinical outcomes and cost-utility between unilateral biportal endoscopic discectomy and percutaneous endoscopic interlaminar discectomy for single-level lumbar disc herniation: a retrospective matched controlled study.\",\"authors\":\"Yi-Fan Yang, Jun-Cheng Yu, Zhi-Wei Zhu, Ya-Wei Li, Zhen Xiao, Cong-Gang Zhi, Zhong Xie, Yi-Jun Kang, Jian Li, Bin Zhou\",\"doi\":\"10.1186/s13018-024-05231-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to compare the efficacy and cost-utility of unilateral biportal endoscopy (UBE) versus percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of single-level lumbar disc herniation (LDH).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 99 patients who underwent either UBE (n = 33) or PEID (n = 66) between July 2022 and December 2023 at the Second Xiangya Hospital. Patients were matched 1:2 based on age, sex, and surgery level to ensure comparability. Clinical outcomes were assessed using Visual Analog Scale (VAS), European Quality of Life-5 Dimensions (EQ-5D), and Oswestry Disability Index (ODI) scores, with quality-adjusted life years (QALYs) calculated for cost-utility analysis. Hospitalization costs were analyzed, and the incremental cost-utility ratio (ICER) was determined.</p><p><strong>Results: </strong>Both UBE and PEID groups demonstrated significant postoperative improvements in VAS, EQ-5D, and ODI scores (p < 0.05). The operative time, blood loss and nursing cost were significantly higher for UBE compared to PEID (p < 0.05). UBE has higher gained QALY and overall costs, but the differences are not statistically significant (p = 0.643 for QALY, p = 0.327 for costs). The Incremental Cost-Effectiveness Ratio (ICER) for UBE compared to PEID was calculated to be $354.5 per QALY gained, indicating that for each additional QALY gained through UBE, an additional cost of $354.5 is incurred compared to PEID.</p><p><strong>Conclusion: </strong>In our single-center study conducted in China, both the UBE and PEID procedures have demonstrated comparable short-term efficacy in alleviating pain and improving functional ability in patients with single-level LDH. UBE procedure demonstrates greater cost-utility than the PEID procedure in cost-utility analysis, despite its longer operative time, higher nursing costs and greater blood loss.</p>\",\"PeriodicalId\":16629,\"journal\":{\"name\":\"Journal of Orthopaedic Surgery and Research\",\"volume\":\"19 1\",\"pages\":\"755\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-11-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562584/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Surgery and Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13018-024-05231-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Surgery and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13018-024-05231-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Comparison of clinical outcomes and cost-utility between unilateral biportal endoscopic discectomy and percutaneous endoscopic interlaminar discectomy for single-level lumbar disc herniation: a retrospective matched controlled study.
Objective: This study aimed to compare the efficacy and cost-utility of unilateral biportal endoscopy (UBE) versus percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of single-level lumbar disc herniation (LDH).
Methods: A retrospective analysis was conducted on 99 patients who underwent either UBE (n = 33) or PEID (n = 66) between July 2022 and December 2023 at the Second Xiangya Hospital. Patients were matched 1:2 based on age, sex, and surgery level to ensure comparability. Clinical outcomes were assessed using Visual Analog Scale (VAS), European Quality of Life-5 Dimensions (EQ-5D), and Oswestry Disability Index (ODI) scores, with quality-adjusted life years (QALYs) calculated for cost-utility analysis. Hospitalization costs were analyzed, and the incremental cost-utility ratio (ICER) was determined.
Results: Both UBE and PEID groups demonstrated significant postoperative improvements in VAS, EQ-5D, and ODI scores (p < 0.05). The operative time, blood loss and nursing cost were significantly higher for UBE compared to PEID (p < 0.05). UBE has higher gained QALY and overall costs, but the differences are not statistically significant (p = 0.643 for QALY, p = 0.327 for costs). The Incremental Cost-Effectiveness Ratio (ICER) for UBE compared to PEID was calculated to be $354.5 per QALY gained, indicating that for each additional QALY gained through UBE, an additional cost of $354.5 is incurred compared to PEID.
Conclusion: In our single-center study conducted in China, both the UBE and PEID procedures have demonstrated comparable short-term efficacy in alleviating pain and improving functional ability in patients with single-level LDH. UBE procedure demonstrates greater cost-utility than the PEID procedure in cost-utility analysis, despite its longer operative time, higher nursing costs and greater blood loss.
期刊介绍：
Journal of Orthopaedic Surgery and Research is an open access journal that encompasses all aspects of clinical and basic research studies related to musculoskeletal issues.
Orthopaedic research is conducted at clinical and basic science levels. With the advancement of new technologies and the increasing expectation and demand from doctors and patients, we are witnessing an enormous growth in clinical orthopaedic research, particularly in the fields of traumatology, spinal surgery, joint replacement, sports medicine, musculoskeletal tumour management, hand microsurgery, foot and ankle surgery, paediatric orthopaedic, and orthopaedic rehabilitation. The involvement of basic science ranges from molecular, cellular, structural and functional perspectives to tissue engineering, gait analysis, automation and robotic surgery. Implant and biomaterial designs are new disciplines that complement clinical applications.
JOSR encourages the publication of multidisciplinary research with collaboration amongst clinicians and scientists from different disciplines, which will be the trend in the coming decades.
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