Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome.

摘要: BACKGROUND: In this era of escalating health care costs and the questionable effectiveness multiple interventions, cost or utility analysis has become cornerstone evidence-based medicine, an influence coverage decisions. Even though studies have been performed over years, extensive literature is lacking for interventional techniques. Cost epidural injections managing chronic low back pain demonstrated highly variable results including a lack in randomized trials contrasting observational studies. There not any large management settings. OBJECTIVES: To assess caudal secondary to lumbar disc herniation, axial discogenic pain, central spinal stenosis, post surgery syndrome. STUDY DESIGN: This based on 4 previously published trials. SETTING: A private, specialty referral center United States. METHODS: Four were conducted assessing clinical with without steroids was direct payment data total 480 patients period 2 years from these Outcome included various measures significant improvement defined as at least 50% reduction disability status. RESULTS: The controlled year follow-up actual reimbursement showed one quality-adjusted life (QALY) $2,206 $2,136 $2,155 $2,191 All clinically positive average per QALY $2,172.50 all $1,966.03 judged be successful. assessment show better lower chronic, intractable that similar price than medical therapy only, physical therapy, manipulation, most cases. LIMITATIONS: limitations include it single evaluation, even analysis. Further, only procedures physician visits included. benefits returning work assessed. CONCLUSION: treatment syndrome spine shows less $2,200 QALY.