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Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a

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Summary
This summary is machine-generated.

Percutaneous laser disc decompression (PLDD) is cheaper than surgery for lumbar disc herniation, offering lower healthcare costs. While economically neutral from a societal view, PLDD shows cost-effectiveness for lower willingness-to-pay thresholds.

Keywords:
Disk herniationlaserpercutaneousspinal intervention

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Area of Science:

  • Health Economics
  • Minimally Invasive Surgery
  • Spine Surgery

Background:

  • Percutaneous laser disc decompression (PLDD) is presumed less expensive than traditional surgery for lumbar disc herniation.
  • Cost-effectiveness of PLDD has not been previously evaluated.

Purpose of the Study:

  • To conduct a cost-utility analysis comparing PLDD with conventional surgery for lumbar disc herniation.
  • To assess the economic implications from both societal and healthcare perspectives.

Main Methods:

  • A randomized controlled trial comparing PLDD and conventional surgery.
  • Quality of life assessment using EQ-5D, SF-36 (SF-6D), and VAS.
  • Cost data collected via patient diaries, including healthcare and non-healthcare use, and work absenteeism.
  • 1-year societal costs compared with 1-year quality-adjusted life years (QALYs).

Main Results:

  • Conventional surgery showed a non-significant QALY gain of 0.033 in the first year (US EQ-5D).
  • PLDD significantly reduced healthcare costs by €1771 (95% CI €303 to €3238).
  • PLDD demonstrated favorable cost-effectiveness at lower willingness-to-pay thresholds, while conventional microdiscectomy became favorable at higher thresholds (€30,000-€70,000).

Conclusions:

  • From a healthcare perspective, PLDD followed by surgery if necessary, is significantly less costly than conventional surgery over 1 year.
  • PLDD represents an economically neutral innovation from a societal viewpoint.
  • The choice between PLDD and conventional surgery depends on the willingness-to-pay threshold for QALYs.