A cost benefit analysis of increasing surgical technology in lumbar spine fusion

Passias, Peter G.; Brown, Avery; Alas, Haddy; Bortz, Cole; Pierce, Katherine E.; Hassanzadeh, Hamid; Labaran, Lawal; Puvanesarajah, Varun; Vasquez-Montes, Dennis; Wang, Erik; Ihejirika-Lomedico, Rivka; Diebo, Bassel G.; Lafage, Virginie; Lafage, Renaud; Sciubba, Daniel M.; Janjua, M. Burhan; Protopsaltis, Themistocles S.; Buckland, Aaron J.; Gerling, Michael C.

doi:10.1016/j.spinee.2020.10.012

Cited by 36 publications

(46 citation statements)

References 30 publications

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“…Most studies were then excluded because they did not meet the “cost‐utility analyses” criterion, or because they were not primary studies reporting results of an economic evaluation (e.g., reviews), or because they were duplicates. After the full‐text screening, 31 studies 31–61 were included for data extraction and quality assessment. Further details are presented in the PRISMA flow diagram (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 lists the characteristics and main findings of the included studies. Thirty‐one 31–61 eligible studies evaluated CUAs of robotic surgery compared with that of laparoscopic surgery, open surgery, and (chemo) radiotherapy, and they were published between 2011 and 2020. Studies were conducted in the following countries: USA ( n = 8 31,33,36,42,49,58,60,61 ), Spain ( n = 8 43,45,47,48,50,51,54,59 ), Canada ( n = 5 35,37,39,41,57 ), UK ( n = 2 32,44 ), Thailand ( n = 2 34,40 ), Finland ( n = 1 46 ), Italy ( n = 1 53 ), Japan ( n = 1 55 ), Lebanon ( n = 1 38 ), Sweden ( n = 1 56 ), and China ( n = 1 52 ).…”

Section: Resultsmentioning

confidence: 99%

“…Thirty‐one 31–61 eligible studies evaluated CUAs of robotic surgery compared with that of laparoscopic surgery, open surgery, and (chemo) radiotherapy, and they were published between 2011 and 2020. Studies were conducted in the following countries: USA ( n = 8 31,33,36,42,49,58,60,61 ), Spain ( n = 8 43,45,47,48,50,51,54,59 ), Canada ( n = 5 35,37,39,41,57 ), UK ( n = 2 32,44 ), Thailand ( n = 2 34,40 ), Finland ( n = 1 46 ), Italy ( n = 1 53 ), Japan ( n = 1 55 ), Lebanon ( n = 1 38 ), Sweden ( n = 1 56 ), and China ( n = 1 52 ). As regards the clinical condition, most studies focused on prostatectomy ( n = 6 32–34,41,55,57 ), followed by proctectomy ( n = 4 43,46,59,60 ) and transoral surgery ( n = 4 35–37,39 ).…”

Section: Resultsmentioning

confidence: 99%

“…Three health system perspectives analyses 32,46,59 reported that surgery costs, hospitalization costs, complications, recurrence, or readmission costs were considered, but only one study 46 included the productivity lost cost due to medical care. As regards the payer analyses, all seven studies 33,35,36,41,50,57,58 included the operative costs, hospitalization costs, complications, recurrence, or readmission costs, while only one study 33 considered the productivity lost cost due to medical care. Four studies 44,51,53,54 did not report the perspective they adopted, they only consider operative costs, hospitalization costs, and readmission costs; no indirect costs were reported.…”

Section: Resultsmentioning

confidence: 99%

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More work is needed on cost‐utility analyses of robotic‐assisted surgery

Bai

Han

et al. 2022

J Evidence Based Medicine

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Objective:To comprehensively analyze the cost-utility of robotic surgery in clinical practice and to investigate the reporting and methodological quality of the related evidence.Methods: Data on cost-utility analyses (CUAs) of robotic surgery were collected in seven electronic databases from the inception to July 2021. The quality of the included studies was assessed using the CHEERs and QHES checklists. A systematic review was performed with the incremental cost-effectiveness ratio as the outcome of interest.Results: Thirty-one CUAs of robotic surgery were eligible. Overall, the identified CUAs were fair to high quality, and 63% of the CUAs ranked the cost-utility of robotic surgery as "favored," 32% categorized as "reject," and the remaining 5% ranked as "unclear."Although a high heterogeneity was present in terms of the study design among the included CUAs, most studies (81.25%) consistently found that robotic surgery was more cost-utility than open surgery for prostatectomy

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

More work is needed on cost‐utility analyses of robotic‐assisted surgery

Bai

Han

et al. 2022

J Evidence Based Medicine

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“…Recent technologies often need expensive support to develop, and after verifying the efficacy of surgery, they will be further promoted and developed to reduce the cost of surgery and bring well-being to critically ill patients. 56 , 57 Comparative studies on the fusion rates of MI-TLIF and O-TLIF in patients with obesity are required to further evaluate their efficacy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Perioperative and Postoperative Outcomes of Minimally Invasive and Open TLIF in Obese Patients: A Systematic Review and Meta‑Analysis

Chen¹,

Lin²,

Rui³

et al. 2022

JPR

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Purpose Previous studies have demonstrated that minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) is comparable to the open approach in terms of efficacy and safety. However, few comparative studies of surgical procedures in patients with obesity show that they may react differently to open-TLIF (O-TLIF) and MI-LTIF approaches. Patients and Methods The main indicators were complications, visual analog scale (VAS) score, and Oswestry Disability Index (ODI) score, and secondary indicators were operative time, blood loss, and hospital stay. Results No significant differences in the VAS and ODI scores for back pain at the last follow-up and wound infection rates were observed between the two groups. Dural tear incidence and complication rate were significantly lower in the MI-TLIF group than that in the O-TLIF group (P = 0.002 and 0.001, respectively). No significant difference in operative time was found between the two groups. There was less blood loss and shorter hospital stay (P = 0.001 and 0.002, respectively) in the MI-TLIF group than that in the O-TLIF group. Conclusion Compared with O-TLIF, MI-TLIF is an effective and safe surgical option for patients with obesity, which resulted in similar improvements in pain and functional disability, as well as a lower complication rate.

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A systematic review on the cost‐effectiveness of the computer‐assisted orthopedic system

Zhuang

et al. 2022

Health Care Science

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Computer‐assisted orthopedic system (CAOS) is rapidly gaining popularity in the field of precision medicine. However, the cost‐effectiveness of CAOS has not been well clarified. We performed this review to summarize and assess the cost‐effectiveness analyses (CEAs) with regard to CAOS. Publications on CEA in CAOS have been searched in PubMed and CEA Registry up to May 31, 2022. The Quality of Health Economic Studies (QHES) instrument was used to estimate the quality of studies. Relationships between qualities and potential factors were also examined. There were 15 eligible studies in the present review. Twelve studies evaluated CAOS joint arthroplasties and found that CAOS joint arthroplasties were cost‐effective compared to manual methods. Three studies focused on spinal surgery, two of which analyzed the cost‐effectiveness of CAOS for patients after spinal fusion, with conflicting results. One study demonstrated that CAOS was cost‐effective in spinal pedicle screw insertion. The mean QHES score of CEAs included was 86.1. The potential factors had no significant relationship with the quality of studies. Based on available studies, our review reflected that CAOS was cost‐effective in the field of joint arthroplasty. While in spinal surgery, the answer was unclear. Current CEAs represent high qualities, and more CEAs are required in the different disciplines of orthopedics where CAOS is employed.

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A cost benefit analysis of increasing surgical technology in lumbar spine fusion

Cited by 36 publications

References 30 publications

More work is needed on cost‐utility analyses of robotic‐assisted surgery

More work is needed on cost‐utility analyses of robotic‐assisted surgery

Comparison of Perioperative and Postoperative Outcomes of Minimally Invasive and Open TLIF in Obese Patients: A Systematic Review and Meta‑Analysis

A systematic review on the cost‐effectiveness of the computer‐assisted orthopedic system

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