Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Cost Effectiveness of Dynamic and Static Interspinous Spacer for Lumbar Spinal Stenosis Compared With Laminectomy



Yaghoubi M1 ; Moradilakeh M1 ; Moradijoo M2 ; Rahimimovaghar V3 ; Zamani N4 ; Naghibzadehtahami A5
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Epidemiology Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

Source: Medical Journal of the Islamic Republic of Iran Published:2016

Abstract

Background: The present study aims to evaluate the cost-effectiveness of Dynamic Interspinous Spacer (Coflex®) and Static Spacer (X-STOP ® ) compared to Laminectomy (LAMI) in patients with lumbar spinal stenosis. Methods: A decision-analysis model was developed to estimate the cost-effectiveness. The effectiveness parameters were obtained from a systematic literature review in relevant databases including PUBMED and EMBASE. A meta-analysis was performed using the STATA statistical package and a random model was used to collect measures of mean difference of visual analogue scale (VAS) pain score before and after intervention in X-stop, Coflex and LAMI (95% confidence intervals). Cost data were obtained from provider and associated literature based on health care provider prospective. We assumed that the probability of the success rate of surgery in each intervention from associated literature and calculated Incremental cost effectiveness ratio. A one-way sensitivity analysis was also carried out. Results: Twenty-four out of 294 studies are included in the Meta-analysis. The overall pooled estimate of the mean difference of VAS pain score were 3.49 (95% CI 3.7-4.2) and 4.14 (95% CI 3.09- 5.19) for X-stop and Coflex, respectively. In addition, we assumed the overall pooled estimate of 5.3 (95% CI 2.15-7.4) on the basis of literature for LAMI. The average cost per LAMI surgery, X-stop and Coflex was US$ 3019, US$ 2022 and US$ 2566, respectively. Incremental cost effectiveness ratio of X-stop and Coflex versus LAMI was US$ 665.9 and US$ 780.7, respectively. Conclusion: Static Interspinous Spacer (X-stop) appears to be the most cost-effective treatment strategy in base case scenario with success rate of LAMI (range between (55%-70%). A sensitivity analysis shows that the increase probability of success rate of LAMI was more than 70 % and less than 55% which lead to the cost effectiveness of the Coflex intervention.
Related Docs
View other Related Docs
1. The Quality of Life of 50-70 Years Old Patients With Orthopedic Spinal Stenosis Surgery. a Follow-Up Study (Descriptive Study), Caspian Journal of Internal Medicine (2023)
2. Effects of Intraoperative-Intrathecal Sufentanil Injection on Postoperati Pain Management After Single Level Lumbar Discectomy, Middle East Journal of Anesthesiology (2010)
3. Analyzing the Effects of Intra-Operation Video-Clip Display on Hemodynamic and Satisfaction of Patients During Lumbar Discectomy Under Spinal Anesthesia, Saudi Journal of Anaesthesia (2013)
4. Posterolateral Instrumented Fusion With and Without Transforaminal Lumbar Interbody Fusion for the Treatment of Adult Isthmic Spondylolisthesis: A Randomized Clinical Trial With 2-Year Follow-Up, Journal of Craniovertebral Junction and Spine (2016)
5. Comparison of Open Surgical Discectomy Versus Plasma-Laser Nucleoplasty in Patients With Single Lumbar Disc Herniation, Journal of Research in Medical Sciences (2015)
6. Effect of High-Dose Intravenous Dexamethasone on Postlumbar Discectomy Pain, Spine (2006)
7. Onabotulinum Toxin a Improves Neurogenic Detrusor Overactivity Following Spinal Cord Injury: A Systematic Review and Meta-Analysis, Spinal Cord (2024)
8. The Cost-Effectiveness and Cost-Utility Analysis of the Use of Enoxaparin Compared With Heparin for Venous Thromboembolism Prophylaxis in Medical Inpatients in Iran, DARU, Journal of Pharmaceutical Sciences (2019)
Experts (# of related papers)
View all Related Experts
Mohammad Reza Safavi (4)
Majid Rezvani (3)
Other Related Docs
9. Investigation of Functional Disability, Psychological Status, and Quality of Life of Patients Undergoing Lumbar Disc Surgery, Journal of Military Medicine (2023)
10. Skew-Symmetric Random Effect Models With Application to a Preventive Cohort Study: Improving Outcomes in Low Back Pain Patients, International Journal of Preventive Medicine (2013)
11. Comparison of the Outcomes of Cage-Stand-Alone With Cage-With-Plate Fixation in One Level and Two Levels for Treating Cervical Disk Diseases, Journal of Craniovertebral Junction and Spine (2018)
12. Lumbar Sacralization and L4-L5 Microdiscectomy, a Prospective Cohort Study on Radiologic and Clinical Outcomes, World Neurosurgery: X (2024)
13. Comparison of 1-Stage Versus 2-Stage Decompression, Fusion and Instrumentation Surgery in Patients With Coexisting Cervical and Lumbar Degenerative Spondylotic Disorders; a Prospective, Randomized, Controlled Clinical Trial Study, Journal of Isfahan Medical School (2016)
14. Single Level Cervical Disc Herniation: A Questionnaire Based Study on Current Surgical Practices, Indian Journal of Orthopaedics (2009)
15. A Short-Term Oral Corticosteroid for Refractory Lumbar Spinal Stenosis: A Double-Blinded Randomized Placebo-Controlled Clinical Trial, International Journal of Rehabilitation Research (2020)
16. Comparing the Prophylactic Effects of Oral Gabapentin, Pregabalin, and Celecoxib on Postoperative Pain Management in Orthopedic Surgery of the Lower Extremity: A Double-Blind Randomized Controlled Trial, Journal of Research in Medical Sciences (2020)
17. Value of Spinal Infection Treatment Evaluation Score, Pola Classification, and Brighton Spondylodiscitis Score From Decision to Surgery in Patients With Spondylodiscitis: A Receiveroperating Characteristic Curve Analysis, Asian Spine Journal (2024)
18. Spinal Anesthesia Versus General Anesthesia for Elective Lumbar Spine Surgery: A Randomized Clinical Trial, Journal of Research in Medical Sciences (2011)