经椎间孔内窥镜胸椎椎间盘切除术治疗症状性椎间盘突出比显微椎间盘切除术更具成本效益。

IF 3.6 2区 医学 Q1 CLINICAL NEUROLOGY
Neurospine Pub Date : 2025-03-01 Epub Date: 2025-03-31 DOI:10.14245/ns.2449414.707
Junseok Bae, Pratyush Shahi, Sang-Ho Lee, Han-Joong Keum, Ju-Wan Seok, Yong-Soo Choi, Jin-Sung Kim
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引用次数: 0

摘要

目的:分析经椎间孔内镜下胸椎间盘切除术(TETD)治疗症状性胸椎间盘突出症(TDH)的成本和成本-效果,并与开放式显微椎间盘切除术(MD)进行比较。方法:这项回顾性队列研究纳入了因症状性TDH而接受TETD或MD治疗的患者,随访时间至少为1年。成本分析包括直接成本(初级和二级医院成本)、间接成本(因缺勤造成的工资损失)、总成本(直接+间接)和成本效益(每质量调整生命年成本[QALY]和增量成本效益比[ICER])。临床结果包括患者报告的结果测量(Oswestry残疾指数[ODI]、36项简短健康调查[SF-36])、获得的QALY、1年后的再手术率和再入院率。比较TETD组和MD组的结果。结果:共纳入111例患者(TETD 57例,MD 54例)。TETD的直接成本(6270美元TETD vs. 7410美元MD, p < 0.01)、间接成本(1250美元TETD vs. 1450美元MD, p < 0.01)、总成本(7520美元TETD vs. 8860美元MD, p < 0.01)和每QALY成本(31333美元TETD vs. 44300美元MD, p < 0.01)显著低于MD。TETD的ICER为- 33,500美元。1年时,TETD组ODI(46%比36%,p < 0.01)和SF-36(64%比53%,p < 0.01)的改善显著高于MD组,QALY的改善显著高于MD组(0.24比0.2,p < 0.01)。两组再手术率和再入院率无显著差异。结论:在适当选择的有症状的TDH患者中,与MD相比,TETD表现出更好的临床结果,更低的总成本和更好的成本效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations.

Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations.

Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc Herniations.

Objective: To analyze costs and cost-effectiveness of transforaminal endoscopic thoracic discectomy (TETD) for the treatment of symptomatic thoracic disc herniation (TDH) and compare it with open microdiscectomy (MD).

Methods: This retrospective cohort study included patients who underwent TETD or MD for symptomatic TDH and had a minimum follow-up of 1 year. Cost analysis included direct costs (primary and secondary hospital costs), indirect costs (lost wages due to work absence), total costs (direct + indirect), and cost-effectiveness (cost per quality-adjusted life year [QALY] and incremental cost-effectiveness ratio [ICER]). Clinical outcomes included patient-reported outcome measures (Oswestry Disability Index [ODI], 36-item Short Form health survey [SF-36]), QALY gained, and reoperation and readmission rates at 1 year. TETD and MD groups were compared for outcome measures.

Results: A total of 111 patients (57 TETD, 54 MD) were included. The direct ($6,270 TETD vs. $7,410 MD, p < 0.01), indirect costs ($1,250 TETD vs. $1,450 MD, p < 0.01), total costs ($7,520 TETD vs. $8,860 MD, p < 0.01), and cost per QALY ($31,333 TETD vs. $44,300 MD, p < 0.01) were significantly lower for TETD compared to MD. ICER of TETD was found to be -$33,500. At 1 year, TETD group showed significantly greater improvement in ODI (46% vs. 36%, p < 0.01) and SF-36 (64% vs. 53%, p < 0.01) and significantly greater QALY gained (0.24 vs. 0.2, p < 0.01) compared to MD group. No significant difference was found in reoperation and readmission rates.

Conclusion: TETD demonstrated significantly better clinical outcomes, lower overall costs, and better cost-effectiveness than MD in appropriately selected patients of symptomatic TDH.

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来源期刊
Neurospine
Neurospine Multiple-
CiteScore
5.80
自引率
18.80%
发文量
93
审稿时长
10 weeks
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