The present study was to see the effect of minimally invasive neural foraminotomy for lumbar foraminal stenosis with unilateral radicular pain. Traditionally, fusion was was done for the patients, but recent development enable surgeon to decompress neural foramen without rigid spinal fusion. Although, clinical effect of neural foraminotomy may have limitation in attaining a comparable result to fusion surgery, a cost-effective analysis may reveal a result in a different perspective. In this regard, we designed a prospective cohort study to see the cost-effectiveness of neural foraminotomy compared to fusion surgery.
Control: 1-2 levels fusion surgery Intervention: neural foraminotomy Inclusion patients between 40 - 100 years. No improvement despite nonsurgical treatment for more than 3 months. No history of lumbar fusion surgery Single or double-level lumbar foraminal stenosis with corresponding leg pain Exclusion Severe neurological deficit (motor grade less than Grade III) Combined inflammatory joint disease Combined neurodegenerative disease such as Parkinson's disease or dementia Combined cancer, traumatic fracture marked spinal deformity (C7 sagittal vertical axis \> 10cm) Surgery and follow-up Patients underwent foraminotomy and visits outpatient clinical at determined time points (postoperative month 1, 6, 12 and 24 months) Their clinical outcomes were recorded at each visit. Their medical costs were retrieved at the time of analysis by using hospital records. Statistical analysis means: T-test
Study Type
OBSERVATIONAL
Enrollment
52
lumbar foraminal decompression with endoscopic instruments.
Fusion surgery for patients with foraminal stenosis
Seoul National University Hospital
Seoul, Korea, South Korea
Cost-effectiveness
cost to increased one quality adjusted life year (QALY) after surgical treatment
Time frame: preoperation
Cost-effectiveness
cost to increased one quality adjusted life year (QALY) after surgical treatment
Time frame: postoperative 6 months
Cost-effectiveness
cost to increased one quality adjusted life year (QALY) after surgical treatment
Time frame: postoperative 1 year
Cost-effectiveness
cost to increased one quality adjusted life year (QALY) after surgical treatment
Time frame: postoperative 2 years
Oswestry disability index (ODI)
ODI was recorded at preoperation, postoperative 6 months, 1 year and 2 years.
Time frame: preoperation
Oswestry disability index (ODI)
ODI was recorded at preoperation, postoperative 6 months, 1 year and 2 years.
Time frame: postoperative 6 months
Oswestry disability index (ODI)
ODI was recorded at preoperation, postoperative 6 months, 1 year and 2 years.
Time frame: postoperative 1 year
Oswestry disability index (ODI)
ODI was recorded at preoperation, postoperative 6 months, 1 year and 2 years.
Time frame: postoperative 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Numeric rating scale(NRS) of pain on back (NRS-B) and legs (NRS-L)
NRS-B and NRS-L were recorded at preoperation, postoperative 6 months, 1 year and 2 years. Numeric rating scale (NRS) : Scale from 0 to 10. Zero means there's no pain and 10 means the maximum pain.
Time frame: preoperation
Numeric rating scale(NRS) of pain on back (NRS-B) and legs (NRS-L)
NRS-B and NRS-L were recorded at preoperation, postoperative 6 months, 1 year and 2 years. Numeric rating scale (NRS) : Scale from 0 to 10. Zero means there's no pain and 10 means the maximum pain.
Time frame: postoperative 6 months
Numeric rating scale(NRS) of pain on back (NRS-B) and legs (NRS-L)
NRS-B and NRS-L were recorded at preoperation, postoperative 6 months, 1 year and 2 years. Numeric rating scale (NRS) : Scale from 0 to 10. Zero means there's no pain and 10 means the maximum pain.
Time frame: postoperative 1 year
Numeric rating scale(NRS) of pain on back (NRS-B) and legs (NRS-L)
NRS-B and NRS-L were recorded at preoperation, postoperative 6 months, 1 year and 2 years. Numeric rating scale (NRS) : Scale from 0 to 10. Zero means there's no pain and 10 means the maximum pain.
Time frame: postoperative 2 years.