Economic comparisons of endoscopic spine surgery: a systematic review.

Autor: Golan JD; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada. jeff.golan@mcgill.ca., Elkaim LM; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.; Division of Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada., Alrashidi Q; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada., Georgiopoulos M; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada., Lasry O; Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, QC, Canada.; Division of Clinical Epidemiology, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2023 Aug; Vol. 32 (8), pp. 2627-2636. Date of Electronic Publication: 2023 Apr 19.
DOI: 10.1007/s00586-023-07699-0
Abstrakt: Purpose: Full-endoscopic techniques are minimally invasive surgery alternatives to traditional spinal surgery. We performed a systematic review of the literature to assess the costs of these techniques compared to traditional approaches.
Methods: A systematic review of the literature was performed for economic evaluations that compare endoscopic decompressions of the lumbar spine for stenosis or disc herniation to open or microsurgical decompressions. The search was performed in the following databases: Medline, Embase Classic, Embase, and Central Cochrane library, from January 1, 2005, to October 22, 2022. The included studies were each evaluated according to a formal assessment checklist to evaluate the quality of economic evaluations based on 35 criteria.
Result: A total of 1153 studies were identified, with 9 articles included in the final analysis. In evaluating the quality of economic evaluations, the study with the fewest met criteria scored 9/35 and the study with the most met criteria scored 28/35. Only 3 studies completed cost-effectiveness analyses. Surgical procedure duration varied between studies, but hospital length of stays were consistently shorter with endoscopy. While endoscopy was more frequently associated with higher operating costs, studies that measured healthcare and societal costs found endoscopy to be advantageous.
Conclusion: Endoscopic spine surgery was found to be cost-effective in treating patients with lumbar stenosis and disc herniation when compared to standard microscopic approaches from a societal perspective. More well-designed economic evaluations investigating the cost-effectiveness of endoscopic spine procedures are needed to further support these findings.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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