Lateral lumbar interbody fusion (LLIF) reduces total lifetime cost compared with posterior lumbar interbody fusion (PLIF) for single-level lumbar spinal fusion surgery: a cost-utility analysis in Thailand

Lumbar interbody fusion techniques treat degenerative lumbar diseases effectively. Minimally invasive lateral lumbar interbody fusion (LLIF) decreases soft tissue disruption and accelerates recovery better than standard open posterior lumbar interbody fusion (PLIF). However, the material cost of LLI...

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Published in:Journal of orthopaedic surgery and research 2023-02, Vol.18 (1), p.115-115, Article 115
Main Authors: Boonsirikamchai, Win, Phisalpapra, Pochamana, Kositamongkol, Chayanis, Korwutthikulrangsri, Ekkapoj, Ruangchainikom, Monchai, Sutipornpalangkul, Werasak
Format: Article
Language:English
Subjects:
Aged
Back pain
Back surgery
Cardiovascular disease
Cost analysis
Cost-Benefit Analysis
Cost-effectiveness analysis
Cost-utility analysis
Decision trees
Developing countries
Economic models
Health technology assessment
Hospitals
Humans
Incremental cost-effectiveness ratio (ICER)
Lateral lumbar interbody fusion (LLIF)
LDCs
Length of stay
Lumbar Vertebrae - surgery
Middle Aged
Orthopedics
Patients
Population
Posterior lumbar interbody fusion (PLIF)
Quality of Life
Quality-adjusted life-year (QALY)
Questionnaires
Retrospective Studies
Sensitivity analysis
Spinal Fusion - methods
Spondylosis
Survival analysis
Thailand - epidemiology
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Summary:Lumbar interbody fusion techniques treat degenerative lumbar diseases effectively. Minimally invasive lateral lumbar interbody fusion (LLIF) decreases soft tissue disruption and accelerates recovery better than standard open posterior lumbar interbody fusion (PLIF). However, the material cost of LLIF is high, especially in Thailand. The cost-effectiveness of LLIF and PLIF in developing countries is unclear. This study compared the cost-utility and clinical outcomes of LLIF and PLIF in Thailand. Data from patients with lumbar spondylosis who underwent single-level LLIF and PLIF between 2014 and 2020 were retrospectively reviewed. Preoperative and 1-year follow-up EuroQol-5D-5L and healthcare costs were collected. A cost-utility analysis with a lifetime time horizon was performed using a societal perspective. Outcomes are reported as the incremental cost-effectiveness ratio (ICER) and quality-adjusted life-year (QALY) gained. A Thai willingness-to-pay threshold of 5003 US dollars (USD) per QALY gained was used. The 136 enrolled patients had a mean age of 62.26 ± 11.66 years. Fifty-nine patients underwent LLIF, while 77 underwent PLIF. The PLIF group experienced greater estimated blood loss (458.96 vs 167.03 ml; P 
ISSN:1749-799X
1749-799X
DOI:10.1186/s13018-023-03588-w