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Total Disc Replacement Versus Anterior-Posterior Interbody Fusion in the Lumbar Spine and Lumbosacral Junction: A Cost Analysis
- Source :
- Global Spine Journal
- Publication Year :
- 2017
- Publisher :
- SAGE Publications, 2017.
-
Abstract
- Study Design:Prospective observational cohort study.Objectives:To analyze clinical and economic results in patients with degenerative disc disease in the lumbar area for patients who received combined anterior and posterior fusion or total disc replacement (TDR).Methods:The study included 75 patients, 38 in the fusion group and 37 in the TDR group, who received either anterior/posterior fusion or TDR for lumbar disc disease from January 2005 to December 2008 with a minimum follow-up of 24 months. We collected data with regard to clinical parameters, demographics, visual analogue scale scores, Oswestry Disability Index scores, SF-36 and SF-6D data, surgery time, amount of blood loss, transfusion of blood products, number of levels, duration of hospital stay, and complications. For cost analysis, general infrastructure, theatre costs, as well as implant costs were examined, leading to primary hospital costs. Furthermore, average revision costs were examined, based on the actual data. Statistical analysis was performed using t tests for normal contribution and Mann-Whitney test for skew distributed values. The significance level was set to .05.Results:There was a higher surgery time, more blood loss, and longer hospital stay for the fusion group, compared with the TDR group. In addition, the hospital costs for the primary procedure and revision were 35% higher in the fusion group. The clinical data in terms of SF-36 and SF-6D showed no difference between these 2 groups.Conclusions:TDR is a good alternative to anterior and posterior lumbar fusion in terms of short follow-up analysis for clinical data and cost analysis. General advice cannot be given due to missing data for long-term costs in terms of surgical treatment of adjacent level or further fusion techniques.
- Subjects :
- medicine.medical_specialty
Total disc replacement
Cost effectiveness
hospital costs
cost-effectivene
Degenerative disc disease
03 medical and health sciences
0302 clinical medicine
Lumbar
Medicine
Orthopedics and Sports Medicine
cost-effectiveness
030222 orthopedics
business.industry
anterior-posterior fusion
Original Articles
medicine.disease
Surgery
degenerative disc disease
Cohort
Cost analysis
Lumbar spine
hospital cost
total disc replacement
Neurology (clinical)
business
030217 neurology & neurosurgery
Lumbosacral joint
DDD
Subjects
Details
- ISSN :
- 21925690 and 21925682
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Global Spine Journal
- Accession number :
- edsair.doi.dedup.....6f327e6c34a5dfea57f00572fc2b597d