Cost-effectiveness of image-guided spine surgery.
作者： Robert Green Watkins , Akash Gupta , Robert Green Watkins
DOI: 10.2174/1874325001004010228
关键词: Spine surgery 、 Surgery 、 Screw placement 、 Pedicle screw instrumentation 、 Cost savings 、 Cost effectiveness 、 Medicine 、 Pedicle screw 、 Image guidance
摘要: Objective To determine if image-guided spine surgery is cost effective. Methods A prospective case series of the first 100 patients undergoing thoracolumbar pedicle screw instrumentation under image-guidance was compared to a retrospective control group last who underwent placement prior use image-guidance. The system NaviVision (Vector Vision-BrainLAB) and Arcadis Orbic (Siemens). Results rate revision reduced from 3% 0% with image guidance (p=0.08). savings for screws $71,286 per cases. Time required 20 minutes 2 screws, 29 4 38 6 50 min 8 screws. Cost time can be estimated by subtracting currently used techniques without above averages, then multiplying $93 minute. approximate costs navigation $475,000 ( $225,000 Vector Vision-BrainLAB $250,000 Orbic-Siemens). Conclusion Image may effective in practices heavy volume, that perform difficult cases, require long surgical times
benthamopen.com
openorthopaedicsjournal.com参考文章(35)
Xi-sheng Weng, Jin Lin, Gui-xing Qiu, Jian-guo Zhang, Ye Tian, Shu-gang Li, Yi-peng Wang, Qi-bin Ye, Jia Zhang, Xin-yu Yang, Complications associated with the technique of pedicle screw fixation Acta Academiae Medicinae Sinicae. ,vol. 24, pp. 294- ,(2002)
Kevin T. Foley, Maurice M. Smith, Image-guided spine surgery. Neurosurgery Clinics of North America. ,vol. 7, pp. 171- 186 ,(1996) , 10.1016/S1042-3680(18)30385-1
Lothar Wiesner, Ralph Kothe, Klaus-Peter Schulitz, Wolfgang Rüther, Clinical Evaluation and Computed Tomography Scan Analysis of Screw Tracts After Percutaneous Insertion of Pedicle Screws in the Lumbar Spine Spine. ,vol. 25, pp. 615- 621 ,(2000) , 10.1097/00007632-200003010-00013
Florian T. Gebhard, Michael D. Kraus, Eugen Schneider, Ulrich C. Liener, Lothar Kinzl, Markus Arand, Does computer-assisted spine surgery reduce intraoperative radiation doses? Spine. ,vol. 31, pp. 2024- 2027 ,(2006) , 10.1097/01.BRS.0000229250.69369.AC
Y. Raja Rampersaud, Kevin T. Foley, Alfred C. Shen, Scott Williams, Milo Solomito, Radiation exposure to the spine surgeon during fluoroscopically assisted pedicle screw insertion. Spine. ,vol. 25, pp. 2637- 2645 ,(2000) , 10.1097/00007632-200010150-00016
Stephen I. Esses, Barton L. Sachs, Vadim Dreyzin, Complications associated with the technique of pedicle screw fixation. A selected survey of ABS members. Spine. ,vol. 18, pp. 2231- 2239 ,(1993) , 10.1097/00007632-199311000-00015
T. Laine, K. Mäkitalo, D. Schlenzka, K. Tallroth, M. Poussa, A. Alho, Accuracy of pedicle screw insertion: A prospective CT study in 30 low back patients European Spine Journal. ,vol. 6, pp. 402- 405 ,(1997) , 10.1007/BF01834068
Timo Laine, Dietrich Schlenzka, Kirsti Mäkitalo, Kaj Tallroth, Lutz-P Nolte, Heiko Visarius, Improved accuracy of pedicle screw insertion with computer-assisted surgery. A prospective clinical trial of 30 patients. Spine. ,vol. 22, pp. 1254- 1258 ,(1997) , 10.1097/00007632-199706010-00018
P. Merloz, J. Tonetti, L. Pittet, M. Coulomb, S. Lavalle??, P. Sautot, Pedicle screw placement using image guided techniques. Clinical Orthopaedics and Related Research. ,vol. 354, pp. 39- 48 ,(1998) , 10.1097/00003086-199809000-00006
David A. Levin, John A. Bendo, Martin Quirno, Thomas Errico, Jeffrey Goldstein, Jeffrey Spivak, Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion. Spine. ,vol. 32, pp. 2905- 2909 ,(2007) , 10.1097/BRS.0B013E31815B84AE