Tubular Diskectomy vs Conventional Microdiskectomy for the Treatment of Lumbar Disk-Related Sciatica: Cost Utility Analysis Alongside a Double-Blind Randomized Controlled Trial

摘要: BACKGROUND Conventional microdiskectomy is the most frequently performed surgery for patients with sciatica caused by lumbar disk herniation. Transmuscular tubular diskectomy has been introduced to increase rate of recovery, although evidence its efficacy lacking. OBJECTIVE To determine whether a favorable cost-effectiveness compared conventional attained. METHODS Cost utility analysis was alongside double-blind randomized controlled trial conducted among 325 related lasting >6 8 weeks at 7 Dutch hospitals comparing microdiskectomy. Main outcome measures were quality-adjusted life-years 1 year and societal costs, estimated from patient reported utilities (US Netherlands EuroQol, Short Form Health Survey-6D, Visual Analog Scale) diaries on costs (health care, productivity). RESULTS Quality-adjusted during all 4 quarters according not statistically different between (difference US -0.012; 95% confidence interval, -0.046 0.021). From healthcare perspective, resulted in nonsignificantly higher $460; -243 1163). nonsignificant difference $1491 (95% -1335 4318) favor found. The differences result low probability that more cost-effective than CONCLUSION Tubular unlikely be