Cost-effectiveness analysis in minimally invasive spine surgery

Area of Science:

• Health Economics
• Neurosurgery
• Surgical Innovation

Background:

• The healthcare system is increasingly focused on value-based care, emphasizing cost-effectiveness and utility.
• This shift necessitates evaluating the economic impact of various medical interventions, including surgical procedures.

Purpose of the Study:

• To analyze the available literature on the costs associated with minimally invasive spine surgery (MISS).
• To compare the cost-effectiveness of MISS with traditional open spine surgery.

Main Methods:

• A comprehensive literature review was conducted using PubMed, the Cost-Effectiveness Analysis (CEA) Registry, and the National Health Service Economic Evaluation Database (NHS EED).
• Studies reporting costs for MISS were included; articles lacking cost, CEA, CUA, QALY, quality, or outcomes data were excluded.

Main Results:

• Fourteen studies involving 12,425 patients were analyzed, comparing MISS to open procedures.
• MISS demonstrated cost savings ranging from 2.54% to 33.68% compared to open surgery.
• MISS was associated with shorter hospital stays (0.93–5.1 days vs. 1.53–12 days) and lower estimated blood loss (EBL) (10–392.5 ml vs. 55–535.5 ml).

Conclusions:

• Current literature on MISS costs lacks standardized reporting methods.
• Preliminary findings suggest MISS offers both cost savings and improved outcomes compared to open surgery.
• Further Level I CEA/CUA studies with standardized cost/QALY evaluations are required for definitive conclusions on MISS cost-effectiveness.