Peloza John H, Millgram Michael A, Jacobian Erel, Kolsky Daniel E, Guyer Richard D, Le Huec Jean-Charles, Ashkenazi Ely
Center for Spine Care, Dallas, TX, 75287, USA.
Israel Spine Center, Assuta Hospital, Assuta Medical Centers, 69710, Tel Aviv, Israel.
Pharmacoecon Open. 2021 Sep;5(3):519-531. doi: 10.1007/s41669-020-00256-1. Epub 2021 Jan 19.
Transforaminal lumbar interbody fusion (TLIF) represents a commonly performed spinal procedure that poses a significant financial burden on patients, hospitals and insurers. Reducing these costs, while maintaining efficacy, may be assisted by a new powered endplate preparation device, designed to shorten procedural time while offering positive impacts on other elements that contribute to the cost of care.
The aim of the study was to assess and compare the individual cost elements of TLIF procedures with and without the use of the device, to determine whether application of this technology translated into any material procedural savings.
The records of 208 single-level TLIF procedures in a single hospital were reviewed. Surgical time, length of hospital stay, blood loss, infection rate, and other parameters were compared for the cases where the device was used (device group; n = 143) and cases which used standard tools (control group; n = 65). The cost per unit of each element was derived from the literature, online resources, and the hospital's financial department.
The analysis revealed a shorter surgery duration in the device group (23 min, after controlling for procedure year and patient characteristics; statistically significant at p < 0.001) and lower complication and readmission rates (p = 0.67 and p = 0.21, respectively) associated with the use of the device, leading to a statistically significant cost reduction of approximately 2060 US dollars (US$) (p < 0.01).
The study suggests that use of the device may lead to a cost reduction and shorter procedure without deteriorating the clinical outcome.
经椎间孔腰椎椎体间融合术（TLIF）是一种常见的脊柱手术，给患者、医院和保险公司带来了巨大的经济负担。一种新型的动力终板准备装置可能有助于降低这些成本，同时保持疗效，该装置旨在缩短手术时间，并对其他影响护理成本的因素产生积极影响。
本研究的目的是评估和比较使用和不使用该装置的TLIF手术的各项成本要素，以确定该技术的应用是否能带来实际的手术成本节约。
回顾了一家医院208例单节段TLIF手术的记录。比较了使用该装置的病例（装置组；n = 143）和使用标准工具的病例（对照组；n = 65）的手术时间、住院时间、失血量、感染率和其他参数。每个要素的单位成本来自文献、在线资源和医院财务部门。
分析显示，装置组的手术时间较短（控制手术年份和患者特征后为23分钟；p < 0.001，具有统计学意义），使用该装置的并发症和再入院率较低（分别为p = 0.67和p = 0.21），导致成本显著降低约2060美元（p < 0.01）。
该研究表明，使用该装置可能会降低成本、缩短手术时间，且不会使临床结果恶化。
