Cost-effectiveness Analysis of Different Laminoplasty Procedures to Multi-level Cervical Stenosis
Date Issued
2007
Date
2007
Author(s)
Huang, Sheng-Po
DOI
zh-TW
Abstract
Background：The compression of cervical spine and nerve roots due to cervical stenosis, if patient’s condition is serious, it will cause severe disability. Laminoplasty is a practical surgical techmique for the treatment of multi-level cervical stenosis. There were few studies on terms of costs and effectiveness between open-door laminoplasty and midline open-book laminoplasty.
Objective：This study is from a point of assurer. It aimed at people with multi-level cervical stenosis, analyzed and compared the outcome of costs and effectiveness of open-door laminoplasty to that of midline open-book laminoplasty.
Methods：This study retrospectively analyzed on a medical center located at Taipei from January 1 2000 to February 17 2007. Patients’ diadnosed as ICD-9-CM 721.0、722.91、723-724 and treated with laminoplasty were screened to select 78 individuals. According to approach, patients were classified into two groups, namely open-door laminoplasty and midline open-book laminoplasty. Analyzing the two groups in the days after surgery, average operating period, estimated intraoperative blood loss, difference between preoperative and poatoperative Nurick scale, difference between preoperative and poatoperative JOA scale, JOA recocer rate, difference between preoperative and poatoperative canal diameter extent, difference between preoperative and poatoperative canal diameter augment ratio. The analysis was carried out with T-test to study the difference between the two groups.
Results：There was no significant difference in the days after surgery, average operating period, estimated intraoperative blood loss, difference between preoperative and poatoperative Nurick scale, difference between preoperative and poatoperative JOA scale and JOA recocer rate between open-door laminoplasty group and midline open-book laminoplasty group. In the term of medical cost, midline open-book laminoplasty group was highter. In terms of post-operative canal diameter extent and augment ratio, open-door laminoplasty group was longer and higher. Compared which laminoplasty is ascendant in JOA scale recover rate and post-operative canal diameter augment ratio, open-door laminoplasty was better to demonstrate more cost-effectiveness option of the procedures in our study.
Conclusions：In our study, mentioning surgical techmique for the treatment of multi-level cervical stenosis, open-door laminoplasty is more cost-effectiveness than midline open-book laminoplasty. The success of the operation ultimately deponds on the surgeon’s judgement, experience, and patient selection. Chosing the patient correctly and treating them adequately, they will get greatest treatment.
Subjects
頸椎狹窄症
脊髓狹窄
椎板整形術
退化性脊髓神經病變
JOA scale量表
Cervical Stenosis
Spinal Stenosis
Laminoplasty
Spondylotic Myelopathy
JOA scale
Type
thesis
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