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Journals / Turkish Neurosurgery / 2019 / Cilt: 29 - Sayı: 5

A Simple Cost-Effectiveness Analysis of Bilateral Decompression via Unilateral Approach versus Instrumented Total Laminectomy and Fusion for Lumbar Spinal Stenosis

Ali Erhan KAYALAR
Mehmet Resid ONEN
Aydin GERİLMEZ
Sait NADERİ
Pages
643–650
DOI
—
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

This study supports the concept thatminimally invasive spine surgery is cost-effective.

📌 3 Key Takeaways

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Objective & Hypothesis:AIM: To compare the clinical and economic results of two different surgical approaches (bilateral decompression via unilateralapproach and instrumented total laminectomy and fusion) in the treatment of lumbar spinal stenosis.MATERIAL and METHODS: The clinical, surgical, and economic aspects of 100 surgically treated patients with lumbar spinalstenosis were retrospectively reviewed.RESULTS: Decompression was performed at 158 levels in 100 patients.
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Key Findings & Data:The most commonly decompressed levels were L4-5 andL3-4.
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Conclusion & Impact:This study supports the concept thatminimally invasive spine surgery is cost-effective.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

AIM: To compare the clinical and economic results of two different surgical approaches (bilateral decompression via unilateralapproach and instrumented total laminectomy and fusion) in the treatment of lumbar spinal stenosis.MATERIAL and METHODS: The clinical, surgical, and economic aspects of 100 surgically treated patients with lumbar spinalstenosis were retrospectively reviewed.RESULTS: Decompression was performed at 158 levels in 100 patients. The most commonly decompressed levels were L4-5 andL3-4. Significant difference was observed between pre- and postoperative visual analog scale scores in both groups (p<0.05). InGroup 1 (instrumented total laminectomy and fusion), the mean surgery cost was 2539.2 USD (mean procedure cost: 1440.1 USD,mean implant cost: 1099.2 USD). In Group 2 (bilateral decompression via unilateral approach) the mean surgery cost was 998.5USD. The cost difference was significant (p<0.05).CONCLUSION: Both instrumented total laminectomy and fusion and bilateral decompression via unilateral approach performedwith and without stabilization showed similar clinical results in patients with lumbar spinal stenosis. However, the cost of surgerywas found to be 2.5-fold higher in the instrumented total laminectomy and fusion group. This study supports the concept thatminimally invasive spine surgery is cost-effective.

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Cite This Article

KAYALAR, A. E., ONEN, M. R., GERİLMEZ, A., NADERİ, S. (2019). A Simple Cost-Effectiveness Analysis of Bilateral Decompression via Unilateral Approach versus Instrumented Total Laminectomy and Fusion for Lumbar Spinal Stenosis. Turkish Neurosurgery, Cilt: 29 - Sayı: 5, 643–650. https://ajindex.com/articles/405294

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References (1)

  1. Alvin MD, Lubelski D, Abdullah KG, Whitmore RG, Benzel EC, Mroz TE: Cost-utility analysis of instrumented fusion versus decompression alone for Grade I L4-L5 spondylolisthesis at 1-year follow-up: A pilot study. Clin Spine Surg 29:80-86, 2016 2. Aryanpur J, Ducker T: Multilevel lumbar laminotomies: An alternative to laminectomy in the treatment of lumbar stenosis. Neurosurgery 26:429-432, 1990 3. Carreon LY, Glassman SD, Ghogawala Z, Mummaneni PV, McGirt MJ, Asher AL: Modeledcost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N(2)QOD data. J Neurosurg Spine 24: 916-921, 2016 4. Cavusoglu H, Turkmenoglu O, Kaya RA, Tuncer C, Colak I, Sahin Y, Aydin Y: Efficacy of unilateral laminectomy for bilateral decompression in lumbar spinal stenosis. Turk Neurosurg 17:100-108, 2007 5. Chatani K: A novel surgical approach to the lumbar spine involving hemilateral split-off of the spinous process to preserve the multifidus muscle: Technical note. J Neurosurg Spine 24:694-699, 2016 6. Choi WS, Oh CH, Ji GY, Shin SC, Lee JB, Park DH, Cho TH: Spinal canal morphology and clinical outcomes of microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis. Eur Spine J 23: 991-998, 2014 7. Deyo RA, Nachemson A, Mirza SK: Spinal fusionsurgery-the case for restraint. N Engl J Med 350:722-726, 2004 8. Dirksmeier P, Parsons IM, Kang J: Microendoscopic and open laminotomy and discectomy in lumbar disc disease. Semin Spine Surg 11:138-146, 1999 9. Fox MW, Onofrio BM, Hanssen AD: Clinical outcomes and radiological instability following decompressive lumbar laminectomy for degenerative spinal stenosis: A comparison of patients undergoing concomitant arthrodesis versus decompressional one. J Neurosurg 85:793-802, 1996 10. Ghogawala Z, Whitmore RG, Watters WC 3rd, Sharan A, Mummaneni PV, Dailey AT, Choudhri TF, Eck JC, Groff MW, Wang JC, Resnick DK, Dhall SS, Kaiser MG: Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 3: Assessment of economic outcome. J Neurosurg Spine 21:14-22, 2014 11. Herkowitz H, Kurz L: Degenerative lumbar spondylolisthesis with spinal stenosis. J Bone Joint 73:802-808: 1991 12. Ji YC, Kim YB, Hwang SN, Park SW, Kwon JT, Min BK: Efficacy of unilateral laminectomy for bilateral decompression in elderly lumbar spinal stenosis. J Korean Neurosurg Soc 37: 410-415, 2005 13. Korovessis P, Papazisis Z, K