Transforaminal Endoscopic Thoracic Discectomy Is More Cost-Effective Than Microdiscectomy for Symptomatic Disc...

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery
• Health Economics

Background:

• Thoracic disc herniation (TDH) presents unique surgical challenges.
• Open microdiscectomy (MD) is a traditional treatment for TDH.
• Transforaminal endoscopic thoracic discectomy (TETD) is an emerging minimally invasive alternative.

Purpose of the Study:

• To compare the costs and cost-effectiveness of TETD versus MD for symptomatic TDH.
• To evaluate clinical outcomes, including patient-reported measures and quality-adjusted life years (QALYs).

Main Methods:

• Retrospective cohort study of 111 patients with symptomatic TDH.
• Analysis of direct, indirect, and total costs.
• Assessment of cost-effectiveness using QALYs and incremental cost-effectiveness ratio (ICER).
• Comparison of Oswestry Disability Index (ODI) and SF-36 scores at 1-year follow-up.

Main Results:

• TETD group showed significantly lower direct ($6,270 vs. $7,410), indirect ($1,250 vs. $1,450), and total costs ($7,520 vs. $8,860) compared to MD.
• Cost per QALY was significantly lower for TETD ($31,333) versus MD ($44,300).
• TETD achieved greater improvements in ODI (46% vs. 36%) and SF-36 (64% vs. 53%) and higher QALY gained (0.24 vs. 0.2).

Conclusions:

• TETD is a more cost-effective treatment for symptomatic TDH than MD.
• TETD offers superior clinical outcomes, including better functional recovery and quality of life.
• TETD represents a favorable alternative for selected patients with symptomatic TDH.