优化骨健康,预防成人脊柱形修复手术:一个平衡分析
Andrew H Kim1, William ElNemer1, Marc Greenberg1
1Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St. 5th Floor, Baltimore, MD, 21205, USA.
Spine deformity
|April 11, 2025
概括
在成人脊柱形 (ASD) 手术中进行手术前的骨健康优化是具有成本效益的. 诸如特里巴拉提德,德诺苏马布和佐勒龙酸之类的治疗方法可以防止因骨质疏松症而导致昂贵的修复手术.
科学领域:
- 整形外科手术 整形外科手术
- 骨的新陈代谢 骨的新陈代谢
- 卫生经济学 卫生经济学
背景情况:
- 成年脊柱形 (ASD) 手术存在由于骨质疏松症的修改风险.
- 在手术前优化骨健康可能会降低修改率和相关成本.
研究的目的:
- 评估术前骨健康优化的经济可行性,以预防ASD患者的骨质疏松症相关修复手术.
- 使用平衡经济建模来确定成本效益.
主要方法:
- 收集了有关DXA扫描和修订ASD手术成本的机构数据.
- 提取了关于骨质疏松患者2年ASD修订率的文献数据.
- 从开放访问数据库中获取的药物成本 (特里巴拉提德,德诺苏马布,佐勒龙酸).
- 计算总优化成本 (DXA + 药物),并根据通货膨胀调整至 2023 美元.
- 进行了平衡分析,以找到绝对风险降低 (ARR) 和需要治疗的数量 (NNT).
主要成果:
- DXA扫描费用: $349.28; 2年修订ASD手术费用: $147,731.78.8美元.
- 优化成本:特里巴拉提德4410.32美元,德诺苏马布3832.78美元,佐勒龙酸1552.61美元.
- 所有的治疗方法在修订率上都是具有成本效益的.
- 特里巴拉提德的平衡点:2.99%的修订减少 (NNT=34); 登诺苏马布:2.59% (NNT=39); 佐勒龙酸:1.05% (NNT=96).
结论:
- 手术前的骨健康优化对于预防ASD患者的骨质疏松症相关修复手术非常具有成本效益.
- 在每34次手术中,teriparatide需要预防1次修复,在每39次手术中,denosumab需要预防1次修复,在每96次手术中,zoledronic acid需要预防1次修复.
更多相关视频
06:45Modified Posterior Vertebral Column Resection for Patients with Thoracolumbar Kyphotic Deformity
Published on: September 16, 2022
2.1K
07:12Semiautomated Longitudinal Microcomputed Tomography-based Quantitative Structural Analysis of a Nude Rat Osteoporosis-related Vertebral Fracture Model
Published on: September 28, 2017
8.1K
相关概念视频
01:27Fractures: Bone Repair
2.8K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
2.8K
01:29Bone Disorders
3.3K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.3K