Hacker R J
Spine (Phila Pa 1976). 1997 Mar 15;22(6):660-5; discussion 665-6. doi: 10.1097/00007632-199703150-00017.
This is a study comparing two groups of patients surgically treated for disabling low back pain. One group was treated with lumbar anteroposterior fusion (360 degrees fusion), the other with posterior lumbar interbody fusion and an interbody fixation device.
To determine which approach provided the best and most cost-effective outcome using similar patient selection criteria.
Others have shown that certain patients with disabling low back pain benefit from lumbar fusion. Although rarely reported, the costs of different surgical treatments appear to vary significantly, whereas the patient outcome may vary little.
Since 1991, 75 patients have been treated Starting in 1993, posterior lumbar interbody fusion BAK was offered to patients as an alternative to 360 degrees fusion. The treating surgeon reviewed the cases. The interbody fixation device used (BAK; Spine-Tech, Inc., Minneapolis, MN) was part of a Food and Drug Administration study. Patient selection criteria included examination, response to conservative therapy, imaging, psychological profile, and discography. North American Spine Society outcome questionnaires, BAK investigation data radiographs, chart entries, billing records and patient interviews were the basis for assessment.
Age, sex compensable injury history and history of previous surgery were similar. Operative time; blood loss, hospitalization time, and total costs were significantly different. There was a quicker return to work and closure of workers compensation claims for the posterior lumbar interbody fusion-BAK group. Patient satisfaction was comparable at last follow-up.
Posterior lumbar interbody fusion-BAK achieves equal patient satisfaction but fiscally surpasses the 360 degrees fusion approach. Today's environment of regulated medical practice requires the surgeon to consider cost effectiveness when performing fusion for low back pain.
这是一项比较两组因致残性腰痛接受手术治疗患者的研究。一组接受腰椎前后路融合术（360度融合），另一组接受后路腰椎椎间融合术及椎间固定装置治疗。
使用相似的患者选择标准确定哪种方法能提供最佳且最具成本效益的结果。
其他人已表明某些患有致残性腰痛的患者可从腰椎融合术中获益。尽管报道较少，但不同手术治疗的费用似乎差异显著，而患者结局可能差异不大。
自1991年起，共治疗了75例患者。从1993年开始，向后路腰椎椎间融合BAK治疗的患者提供360度融合术的替代方案。主刀医生对病例进行了回顾。所使用的椎间固定装置（BAK；Spine-Tech公司，明尼阿波利斯，明尼苏达州）是美国食品药品监督管理局一项研究的一部分。患者选择标准包括体格检查、对保守治疗的反应、影像学检查、心理状况及椎间盘造影。北美脊柱协会结局问卷、BAK调查数据X光片、病历记录、计费记录及患者访谈是评估的基础。
年龄、性别、可补偿损伤史及既往手术史相似。手术时间、失血量、住院时间及总费用有显著差异。后路腰椎椎间融合-BAK组患者恢复工作更快，工伤赔偿申请结案更快。末次随访时患者满意度相当。
后路腰椎椎间融合-BAK术能达到同等的患者满意度，但在费用方面优于360度融合术。当今规范医疗实践的环境要求外科医生在为腰痛患者施行融合术时考虑成本效益。
