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土耳其经皮全内镜下腰椎间盘切除术与显微镜下椎间盘切除术直接成本比较:结果。

Comparison of direct costs of percutaneous full-endoscopic interlaminar lumbar discectomy and microdiscectomy: Results from Turkey.

机构信息

Department of Neurosurgery, Manisa City Hospital, Manisa, Turkey.

Department of Neurosurgery, Memorial Bahcelievler Hospital, Istanbul, Turkey.

出版信息

Ideggyogy Sz. 2021 May 30;74(5-6):197-205. doi: 10.18071/isz.74.0197.

Abstract

BACKGROUND AND PURPOSE

Microdiscectomy (MD) is a stan-dard technique for the surgical treatment of lumbar disc herniation (LDH). Uniportal percutaneous full-endoscopic in-terlaminar lumbar discectomy (PELD) is another surgical op-tion that has become popular owing to reports of shorter hos-pitalization and earlier functional recovery. There are very few articles analyzing the total costs of these two techniques. The purpose of this study was to compare total hospital costs among microdiscectomy (MD) and uniportal percutaneous full-endoscopic interlaminar lumbar discectomy (PELD).

METHODS

Forty patients aged between 22-70 years who underwent PELD or MD with different anesthesia techniques were divided into four groups: (i) PELD-local anesthesia (PELD-Local) (n=10), (ii) PELD-general anesthesia (PELD-General) (n=10), (iii) MD-spinal anesthesia (MD-Spinal) (n=10), (iv) MD-general anesthesia (MD-General) (n=10). Health care costs were defined as the sum of direct costs. Data were then analyzed based on anesthetic modality to produce a direct cost evaluation. Direct costs were compared statistically between MD and PELD groups.

RESULTS

The sum of total costs was $1,249.50 in the PELD-Local group, $1,741.50 in the PELD-General group, $2,015.60 in the MD-Spinal group, and $2,348.70 in the MD-General group. The sum of total costs was higher in the MD-Spinal and MD-General groups than in the PELD-Local and PELD-General groups. The costs of surgical operation, surgical equipment, anesthesia (anesthetist's costs), hospital stay, anesthetic drugs and materials, laboratory wor-kup, nur-sing care, and two main groups (PELD-MD) me-dication diffe-red significantly among the two main groups (PELD-MD) (p<0.01).

CONCLUSION

This study demonstrated that PELD is less costly than MD.

摘要

背景与目的

经皮内窥镜下腰椎间盘切除术(PELD)是一种治疗腰椎间盘突出症(LDH)的标准技术。单通道经皮全内窥镜椎间孔入路腰椎间盘切除术(PELD)是另一种手术选择,由于报告称其住院时间更短且功能恢复更早,因此越来越受欢迎。很少有文章分析这两种技术的总费用。本研究旨在比较经皮内窥镜下腰椎间盘切除术(MD)和单通道经皮全内窥镜椎间孔入路腰椎间盘切除术(PELD)的总住院费用。

方法

40 名年龄在 22-70 岁之间的患者分别接受 PELD 或 MD 手术治疗,麻醉方式不同,分为四组:(i)PELD-局部麻醉(PELD-Local)(n=10),(ii)PELD-全身麻醉(PELD-General)(n=10),(iii)MD-脊髓麻醉(MD-Spinal)(n=10),(iv)MD-全身麻醉(MD-General)(n=10)。医疗保健费用被定义为直接费用的总和。然后根据麻醉方式对数据进行分析,以进行直接成本评估。对 MD 和 PELD 组之间的直接成本进行了统计学比较。

结果

PELD-Local 组的总费用为 1249.50 美元,PELD-General 组的总费用为 1741.50 美元,MD-Spinal 组的总费用为 2015.60 美元,MD-General 组的总费用为 2348.70 美元。MD-Spinal 和 MD-General 组的总费用均高于 PELD-Local 和 PELD-General 组。手术操作、手术设备、麻醉(麻醉师费用)、住院费用、麻醉药物和材料、实验室工作、护理以及两组(PELD-MD)药物的费用存在显著差异(p<0.01)。

结论

本研究表明 PELD 的费用低于 MD。

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