Chung Andrew S, Ballatori Alexander, Ortega Brandon, Min Elliot, Formanek Blake, Liu John, Hsieh Patrick, Hah Raymond, Wang Jeffrey C, Buser Zorica
5116University of Southern California, Los Angeles, CA, USA.
Global Spine J. 2021 Apr;11(1_suppl):30S-36S. doi: 10.1177/2192568220958403. Epub 2020 Sep 25.
Review.
A comparative overview of cost-effectiveness between minimally invasive versus and equivalent open spinal surgeries.
A literature search using PubMed was performed to identify articles of interest. To maximize the capture of studies in our initial search, we combined variants of the terms "cost," "minimally invasive," "spine," "spinal fusion," "decompression" as either keywords or MeSH terms. PearlDiver database was queried for open and minimally invasive surgery (MIS; endoscopic or percutaneous) reimbursements between Q3 2015 and Q2 2018.
In general, MIS techniques appeared to decrease blood loss, shorten hospital lengths of stay, mitigate complications, decrease perioperative pain, and enable quicker return to daily activities when compared to equivalent open surgical techniques. With regard to cost, primarily as a result of these latter benefits, MIS was associated with lower costs of care when compared to equivalent open techniques. However, cost reporting was sparse, and relevant methodology was inconsistent throughout the spine literature. Within the PearlDiver data sets, MIS approaches had lower reimbursements than open approaches for both lumbar posterior fusion and discectomy.
Current data suggests that overall cost-savings may be incurred with use of MIS techniques. However, data reporting on costs lacks in uniformity, making it difficult to formulate any firm conclusions regarding any incremental improvements in cost-effectiveness that may be incurred when utilizing MIS techniques when compared to equivalent open techniques.
综述。
对微创脊柱手术与同等开放性脊柱手术的成本效益进行比较概述。
使用PubMed进行文献检索以确定相关文章。为了在初始检索中最大限度地获取研究，我们将“成本”“微创”“脊柱”“脊柱融合术”“减压”等术语的变体作为关键词或医学主题词进行组合。查询PearlDiver数据库，获取2015年第三季度至2018年第二季度开放性手术和微创手术（MIS；内镜或经皮手术）的报销情况。
总体而言，与同等开放性手术技术相比，MIS技术似乎能减少失血、缩短住院时间、减轻并发症、减少围手术期疼痛，并能使患者更快恢复日常活动。在成本方面，主要由于上述这些益处，与同等开放性技术相比，MIS相关的护理成本更低。然而，成本报告较少，且整个脊柱文献中的相关方法不一致。在PearlDiver数据集中，对于腰椎后路融合术和椎间盘切除术，MIS方法的报销费用低于开放性手术方法。
目前的数据表明，使用MIS技术可能会节省总体成本。然而，成本数据报告缺乏统一性，因此难以就与同等开放性技术相比，使用MIS技术可能带来的成本效益的任何增量改善得出任何确凿结论。
