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Research ArticleMIS
Open Access

Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis

Y. Raja Rampersaud, Randolph Gray, Steven J. Lewis, Eric M. Massicotte and Michael G. Fehlings
International Journal of Spine Surgery January 2011, 5 (2) 29-35; DOI: https://doi.org/10.1016/j.esas.2011.02.001
Y. Raja Rampersaud
aDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
bSpinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
MD
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  • For correspondence: raja.rampersaud@uhn.on.ca
Randolph Gray
bSpinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
MD
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Steven J. Lewis
aDivision of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
bSpinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
MD
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Eric M. Massicotte
bSpinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
cDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
MD
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Michael G. Fehlings
bSpinal Program, Krembil Neuroscience Center, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
cDivision of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
MD, PhD
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Article Figures & Data

Tables

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    Table 1

    Demographics

    VariableOpen groupMIS groupP value
    NMeanSDNMeanSD
    Age (years)4157.0513.383755.1114.98.7826*
    Sex (female)20——19.7263†
    Body mass index (kg/m2)3930.655.723629.846.50
    No. of levels fused‡ 411.490.51371.220.42.0133†
    Estimated blood loss (mls)40797.75564.2737200.41165.12< .0001*
    LOS (days)418.415.45376.081.86.0525*
    Adverse events12——4——< .02†
    Operating room time (hours)413.791.04373.700.90.6794§
    • ↵* Whitney-Mann test.

    • ↵† χ2 test.

    • ↵‡ Two-level fusions were performed in 20 patients in the open cohort and 12 in the MIS cohort.

    • ↵§ t Test.

    • View popup
    Table 2

    Clinical outcomes

    VariableOpenMISP value
    NMeanSDNMeanSD
    ODI at baseline3051.3315.852836.9015.04.0011*
    ODI at 1 y2933.6818.842818.9117.85.0028*
    • ↵* Whitney-Mann test.

    • View popup
    Table 3

    Cost-utility data

    VariableOpenMISP value
    NMeanSDNMeanSD
    Direct cost (Can $)40$18,632.916,197.3236$14,171.933,269.73.0009*
    Utility score at baseline290.490.08280.600.09< .0001†
    Utility score at 1 y290.570.10280.720.09< .0001†
    • ↵* Whitney-Mann test.

    • ↵† t Test.

    • View popup
    Table 4

    Cost-utility analysis, with projections for 2 and 4 years (all cost in Can $)

    CostQALY gained (5% annual discounting of QALY)Cost/QALY
    1 y2 y4 y1 y2 y4 y
    MIS group$14,1830.110.20.38$128,936$ 70,915$37,720
    Open group$18,6330.080.150.28$232,912$122,585$67,510
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International Journal of Spine Surgery
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1 Jan 2011
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Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis
Y. Raja Rampersaud, Randolph Gray, Steven J. Lewis, Eric M. Massicotte, Michael G. Fehlings
International Journal of Spine Surgery Jan 2011, 5 (2) 29-35; DOI: 10.1016/j.esas.2011.02.001

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Cost-utility analysis of posterior minimally invasive fusion compared with conventional open fusion for lumbar spondylolisthesis
Y. Raja Rampersaud, Randolph Gray, Steven J. Lewis, Eric M. Massicotte, Michael G. Fehlings
International Journal of Spine Surgery Jan 2011, 5 (2) 29-35; DOI: 10.1016/j.esas.2011.02.001
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Keywords

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  • Economic
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