Cost-effectiveness of lumbar discectomy for the treatment of herniated intervertebral disc.

摘要: Study Design. A cost-effectiveness analysis of lumbar discectomy based on existing efficacy data and newly gathered cost data. Objectives. For patients with herniated discs unresponsive to conservative management, surgery relieves pain more rapidly but at higher costs than continued medical therapy. We evaluated the for these patients. Summary Background Data. Effectiveness estimates were results a published trial 126 disc randomized surgical or nonsurgical treatment. Quality life values study 83 subjects low back pain. Treatment estimated from insurance 372 treated surgically 1803 medically. Methods. Efficacy weighted by quality estimate quality-adjusted benefit surgery. Cost-effectiveness was calculated in dollar per year gained. Supplemental sources effectiveness provided ranges sensitivity analyses. Results. Surgery increased average expectancy 0.43 years during decade following treatment, similar extending healthy 5 months. Reimbursements $12,550 Nondiscounted 5% discounted $29,200 $33,000 analyses confirmed base-case suggested that overestimated. Replacing main one HMO lowered discectomy's $12,000 life-year Conclusion. carefully selected discs, is cost-effective Discectomy's favorable its substantial effect moderate costs.