Kevin Phan1,2,3, Jarred A Hogan4, Ralph J Mobbs5,6,7. 1. Department of Neurosurgery, University of New South Wales, High Street, Randwick, NSW, Australia. kphan.vc@gmail.com. 2. Neuro Spine Clinic, Suite 7a, Level 7 Prince of Wales Private Hospital, Barker Street, Randwick, NSW, 2031, Australia. kphan.vc@gmail.com. 3. NeuroSpine Surgery Research Group (NSURG), Sydney, Australia. kphan.vc@gmail.com. 4. NeuroSpine Surgery Research Group (NSURG), Sydney, Australia. 5. Department of Neurosurgery, University of New South Wales, High Street, Randwick, NSW, Australia. ralphmobbs@hotmail.com. 6. Neuro Spine Clinic, Suite 7a, Level 7 Prince of Wales Private Hospital, Barker Street, Randwick, NSW, 2031, Australia. ralphmobbs@hotmail.com. 7. NeuroSpine Surgery Research Group (NSURG), Sydney, Australia. ralphmobbs@hotmail.com.
Abstract
PURPOSE: To assess the cost-utility and perioperative costs of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) versus open-TLIF for degenerative lumbar pathologies. METHODS: Relevant articles were identified from six electronic databases. Predefined end points were extracted and meta-analysis conducted from the identified studies. RESULTS: For each study, the direct hospital cost for MI-TLIF was found to be less than that of open-TLIF. When these outcomes were pooled, direct hospital costs were found to be significantly lower in the MI-TLIF group [weighted mean difference (WMD), -$2820; I (2) = 61 %; P < 0.00001]. MI-TLIF was also associated with shorter hospitalization (WMD, 0.99; 95 % CI -1.81, -0.17; I (2) = 96 %; P = 0.02), trend toward reduced complications (relative risk 0.53; 95 % CI 0.23, 1.06; I (2) = 0 %; P = 0.07), and reduced blood loss (WMD, -246.40 mL; I (2) = 98 %; P = 0.003), but was not associated with a significant difference in operation time (WMD, -67.05; 95 % CI -169.44, 35.35; I (2) = 100 %; P = 0.20). CONCLUSIONS: From the limited evidence, the available data suggest a trend of significantly reduced perioperative costs, length of stay, and blood loss for minimally invasive compared with open surgical approaches for TLIF. MI-TLIF may represent an opportunity for optimal utilization and allocation of health-care resources from both a hospital and societal perspective.
PURPOSE: To assess the cost-utility and perioperative costs of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) versus open-TLIF for degenerative lumbar pathologies. METHODS: Relevant articles were identified from six electronic databases. Predefined end points were extracted and meta-analysis conducted from the identified studies. RESULTS: For each study, the direct hospital cost for MI-TLIF was found to be less than that of open-TLIF. When these outcomes were pooled, direct hospital costs were found to be significantly lower in the MI-TLIF group [weighted mean difference (WMD), -$2820; I (2) = 61 %; P < 0.00001]. MI-TLIF was also associated with shorter hospitalization (WMD, 0.99; 95 % CI -1.81, -0.17; I (2) = 96 %; P = 0.02), trend toward reduced complications (relative risk 0.53; 95 % CI 0.23, 1.06; I (2) = 0 %; P = 0.07), and reduced blood loss (WMD, -246.40 mL; I (2) = 98 %; P = 0.003), but was not associated with a significant difference in operation time (WMD, -67.05; 95 % CI -169.44, 35.35; I (2) = 100 %; P = 0.20). CONCLUSIONS: From the limited evidence, the available data suggest a trend of significantly reduced perioperative costs, length of stay, and blood loss for minimally invasive compared with open surgical approaches for TLIF. MI-TLIF may represent an opportunity for optimal utilization and allocation of health-care resources from both a hospital and societal perspective.
Authors: Beverley J Shea; Jeremy M Grimshaw; George A Wells; Maarten Boers; Neil Andersson; Candyce Hamel; Ashley C Porter; Peter Tugwell; David Moher; Lex M Bouter Journal: BMC Med Res Methodol Date: 2007-02-15 Impact factor: 4.615
Authors: Andrew S Chung; Alexander Ballatori; Brandon Ortega; Elliot Min; Blake Formanek; John Liu; Patrick Hsieh; Raymond Hah; Jeffrey C Wang; Zorica Buser Journal: Global Spine J Date: 2020-09-25