Robotic-Assisted vs Nonrobotic-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Cost-Utility Analysis

• Tipo: Artigo em Revista Científica Internacional
• Data: 2022

Autores

Garcia, D (Autor) Outra; Akinduro, OO (Autor) Outra; De Biase, G (Autor) Outra; Sousa Pinto, B (Autor) FMUP; Jerreld, DJ (Autor) Outra; Dholakia, R (Autor) Outra; Borah, B (Autor) Outra; Nottmeier, E (Autor) Outra; Deen, HG (Autor) Outra; Fox, WC (Autor) Outra; Bydon, M (Autor) Outra; Chen, SLY (Autor) Outra; Quinones Hinojosa, A (Autor) Outra; Abode Iyamah, K (Autor) Outra

Revista

A Revista está pendente de validação pelos Serviços Administrativos.

Título: NEUROSURGERY

Vol. 90

Páginas: 192-198

ISSN: 0148-396X

Indexação

ISI Web of Knowledge - 37 Citações

Scopus - 36 Citações

Outras Informações

ID Authenticus: P-00W-1HG

DOI: 10.1227/neu.0000000000001779

Abstract (EN): BACKGROUND:Management of degenerative disease of the spine has evolved to favor minimally invasive techniques, including nonrobotic-assisted and robotic-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Value-based spending is being increasingly implemented to control rising costs in the US healthcare system. With an aging population, it is fundamental to understand which procedure(s) may be most cost-effective.OBJECTIVE:To compare robotic and nonrobotic MIS-TLIF through a cost-utility analysis.METHODS:We considered direct medical costs related to surgical intervention and to the hospital stay, as well as 1-yr utilities. We estimated costs by assessing all cases involving adults undergoing robotic surgery at a single institution and an equal number of patients undergoing nonrobotic surgery, matched by demographic and clinical characteristics. We adopted a willingness to pay of $50 000/quality-adjusted life year (QALY). Uncertainty was addressed by deterministic and probabilistic sensitivity analyses.RESULTS:Costs were estimated based on a total of 76 patients, including 38 undergoing robot-assisted and 38 matched patients undergoing nonrobot MIS-TLIF. Using point estimates, robotic surgery was projected to cost $21 546.80 and to be associated with 0.68 QALY, and nonrobotic surgery was projected to cost $22 398.98 and to be associated with 0.67 QALY. Robotic surgery was found to be more cost-effective strategy, with cost-effectiveness being sensitive operating room/materials and room costs. Probabilistic sensitivity analysis identified robotic surgery as cost-effective in 63% of simulations.CONCLUSION:Our results suggest that at a willingness to pay of $50 000/QALY, robotic-assisted MIS-TLIF was cost-effective in 63% of simulations. Cost-effectiveness depends on operating room and room (admission) costs, with potentially different results under distinct neurosurgical practices.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 7