Cost analysis comparison between conventional microsurgical decompression and full-endoscopic interlaminar...

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Health Economics

Background:

• Lumbar spinal stenosis (LSS) is commonly treated with full-endoscopic interlaminar decompression (MIS) and conventional microsurgical decompression (CD).
• Healthcare cost is a significant factor in choosing between LSS treatment options.
• A comparative cost analysis of MIS and CD for LSS is essential.

Purpose of the Study:

• To perform a cost analysis comparing MIS and CD for LSS.
• To evaluate the economic implications of different surgical approaches for LSS.

Main Methods:

• A decision analysis model was used to compare MIS and CD for LSS over a 1-year period.
• Unit costs for surgical procedures and complication treatments were estimated.
• Complication rates were sourced from existing literature, including reoperation and nonoperative treatments.

Main Results:

• The average total costs were HKD$54,863 for MIS and HKD$52,748 for CD.
• Hospitalization, radiology, and follow-up costs were similar between the two procedures.
• A 3.9% cost difference was attributed to variations in surgical and complication management costs, with MIS being more expensive for surgery but less for complications.

Conclusions:

• Both MIS and CD demonstrate similar clinical effectiveness for LSS.
• The overall cost difference between MIS and CD is minimal.
• Surgeons should prioritize their proficiency to ensure adequate decompression, regardless of the chosen technique.