Cost-effectiveness of minimally invasive midline lumbar interbody fusion versus traditional open transforaminal lumbar interbody fusion

Djurasovic, Mladen; Gum, Jeffrey L.; Crawford, Charles H.; Owens, Kirk; Brown, Morgan; Steele, Portia; Glassman, Steven D.; Carreon, Leah Y.

doi:10.3171/2019.6.spine1965

Cited by 10 publications

(13 citation statements)

References 21 publications

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“…For instance, Christensen et al calculated healthcare related costs using costs of index hospitalization, costs of diagnostic tests, visits to outpatient clinics and the emergency room up to two years postoperative, resulting in a total of $34,436 [32]. Djurasovic et al only included costs of index hospitalization, resulting in a total of $15,867 [39]. Finally, differences could also be explained by year of data collection and quality of the studies.…”

Section: Discussionmentioning

confidence: 99%

“…Study characteristics. Study characteristics of the 16 included studies are summarized in S1 Table. Nine studies had a cost-effectiveness design [31][32][33][34][35][36][37][38][39] and seven were cost analyses [40][41][42][43][44][45][46]. Publication years ranged from 2001 to 2020.…”

Section: Overview Of Studiesmentioning

confidence: 99%

“…Follow-up time ranged from time of hospitalization to two years postoperative. Fifteen studies were performed in the United States of America using United States Dollars [31,[33][34][35][36][37][38][39][40][41][42][43][44][45][46] and one was performed in Europe (Denmark) using Euros [32]. There were no (partial) economic evaluations that compared TLIF and PLIF directly.…”

Section: Overview Of Studiesmentioning

confidence: 99%

“…For this reason, only indirect comparison of TLIF and PLIF was possible. Thirteen studies compared TLIF with other instrumented spine surgery techniques [31][32][33][34][35][36][37][38][39][42][43][44][45]. Three studies compared PLIF with other techniques [40,41,46].…”

Section: Overview Of Studiesmentioning

confidence: 99%

“…Nine TLIF-studies reported mean or cumulative QALY gain measured with EQ-5D, SF-6D or ODI (Oswestry Disability Index) [31][32][33][34][35][36][37][38][39].…”

Section: Overview Of Studiesmentioning

confidence: 99%

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Comparison of (Partial) economic evaluations of transforaminal lumbar interbody fusion (TLIF) versus Posterior lumbar interbody fusion (PLIF) in adults with lumbar spondylolisthesis: A systematic review

et al. 2021

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Introduction The demand for spinal fusion surgery has increased over the last decades. Health care providers should take costs and cost-effectiveness of these surgeries into account. Open transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF) are two widely used techniques for spinal fusion. Earlier research revealed that TLIF is associated with less blood loss, shorter surgical time and sometimes shorter length of hospital stay, while effectiveness of both techniques on back and/or leg pain are equal. Therefore, TLIF could result in lower costs and be more cost-effective than PLIF. This is the first systematic review comparing direct and indirect (partial) economic evaluations of TLIF with PLIF in adults with lumbar spondylolisthesis. Furthermore, methodological quality of included studies was assessed. Methods Searches were conducted in eight databases for reporting on eligibility criteria; TLIF or PLIF, lumbar spondylolisthesis or lumbar instability, and cost. Costs were converted to United States Dollars with reference year 2020. Study quality was assessed using the bias assessment tool of the Cochrane Handbook for Systematic Reviews of Interventions, the Level of Evidence guidelines of the Oxford Centre for Evidence-based Medicine and the Consensus Health Economic Criteria (CHEC) list. Results Of a total of 693 studies, 16 studies were included. Comparison of TLIF and PLIF could only be made indirectly, since no study compared TLIF and PLIF directly. There was a large heterogeneity in health care and societal perspective costs due to different in-, and exclusion criteria, baseline characteristics and the use of costs or charges in calculations. Health care perspective costs, calculated with hospital costs, ranged from $15,867-$43,217 in TLIF-studies and $32,662 in one PLIF-study. Calculated with hospital charges, it ranged from $8,964-$51,469 in TLIF-studies and $21,838-$93,609 in two PLIF-studies. Societal perspective costs and cost-effectiveness, only mentioned in TLIF-studies, ranged from $5,702/QALY-$48,538/QALY and $50,092/QALY-$90,977/QALY, respectively. Overall quality of studies was low. Conclusions This systematic review shows that TLIF and PLIF are expensive techniques. Moreover, firm conclusions about the preferable technique, based on (partial) economic evaluations, cannot be drawn due to limited studies and heterogeneity. Randomized prospective trials and full economical evaluations with direct TLIF and PLIF comparison are needed to obtain high levels of evidence. Furthermore, development of guidelines to perform adequate economic evaluations, specified for the field of interest, will be useful to minimize heterogeneity and maximize transferability of results. Trial registration Prospero-database registration number: CRD42020196869.

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Section: Discussionmentioning

confidence: 99%

Section: Overview Of Studiesmentioning

confidence: 99%

Section: Overview Of Studiesmentioning

confidence: 99%

Section: Overview Of Studiesmentioning

confidence: 99%

“…Nine TLIF-studies reported mean or cumulative QALY gain measured with EQ-5D, SF-6D or ODI (Oswestry Disability Index) [31][32][33][34][35][36][37][38][39].…”

Section: Overview Of Studiesmentioning

confidence: 99%

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