Cost-effectiveness analysis of Endo-ULBD and MIS-TLIF in the treatment of single-segment lumbar spinal stenosis
Objective To explore differences in social benefits brought by different surgical procedures by observing the cost-effectiveness analysis of endoscopic unilateral laminotomy for bilateral decompression ( Endo-ULBD) and minimally in-vasive transforaminal lumbar interbody fusion ( MIS-TLIF) in the treatment of single-segment lumbar spinal stenosis.Meth-ods 86 patients with single-segment lumbar spinal stenosis who underwent surgical treatment from January 1,2022 to Au-gust 1,2023 were collected.Among them,31 patients treated with Endo-ULBD surgery were selected as experimental group.In addition,55 cases treated with MIS-TLIF were selected as control group.All patients were followed up for 3 months after surgery.Postoperative improvement and all the medical costs of the patients were counted to calculate the cost-effectiveness analysis ( C/E) value=total medical costs/postoperative improvement success rate for the treatment of single-segment lum-bar stenosis under different surgical procedures.Results The visual analog pain scale (VAS) and Oswestry dysfunction in-dex ( ODI) of the two groups at different postoperative stages showed significant improvement compared to those before treat-ment,but difference was not statistically significant between groups ( P>0.05).The operation time,intraoperative blood loss and postoperative hospital stay time of the experimental group were significantly better than those of the control group ( P<0.05).By observing the outpatient follow-up of the two groups at 3 months after surgery,it was found that the success rate of operation in the experimental group was 93.55％ ( 29/31),while that in the control group was 94.55％ ( 52/55).Total medical expenses per capita in the experimental group were 7657.90 yuan,and the total medical expenses per capita in the control group were 14703.05 yuan.By comparing the per capita total medical expenses and operation success rates between two groups,it was found that the C/E value of the experimental group was 81.86,while the C/E value of the control group was 155.51.No death,irreversible nerve damage,or even paralysis occurred in both groups.Conclusion Endo-ULBD surgery is not significantly different from MIS-TLIF surgery in terms of clinical efficacy,whereas Endo-ULBD for lumbar spi-nal stenosis has the advantages of less trauma,shorter operation time,quicker recovery,and lower cost,which has a better social benefit and is an effective alternative for the treatment of lumbar spinal stenosis.
万方数据
维普
