Cost-Effectiveness Analysis of Extended Conservative Therapy Versus Surgical Intervention in the Management of Herniated Lumbar Intervertebral Disc

Shvartzman, L; E, Weingarten; Sherry, H.; Levin, Shany; Persaud, Andrea N.

doi:10.1097/00007632-199202000-00010

Cited by 96 publications

(45 citation statements)

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“…Six studies 62,72,87,91,98,99 compared disc surgery with usual care; the overall findings for four 62,72,87,91 included in the meta-analysis showed a statistically significant difference in favour of surgery. Two were RCTs, for which the duration of follow-up ranged from 1 year to 10 years.…”

Section: Condition-specific Outcome Measures At Medium-term Follow-upmentioning

confidence: 98%

“…Four studies 62,68,80,87 included acute sciatica, for which the comparator included exercise therapy, 68 non-opioids 80 and usual care. 62,87 Just over half of the disc surgery studies were RCTs. There were only a small number of good-quality studies, two of which compared disc surgery with usual care (Table 16).…”

Section: Summary Of Overall Findings For Disc Surgery Compared With Amentioning

confidence: 99%

See 1 more Smart Citation

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTAThe clinical effectiveness and costeffectiveness of management strategies for sciatica: systematic review and economic model NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA pro...

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Section: Condition-specific Outcome Measures At Medium-term Follow-upmentioning

confidence: 98%

Section: Summary Of Overall Findings For Disc Surgery Compared With Amentioning

confidence: 99%

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Lewis

Williams²,

Matar³

et al. 2011

Health Technol Assess

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“…There is now an increasing body of literature dealing specifically with the cost-effectiveness of lumbar discectomy for the treatment of herniated intervertebral discs. 2,4,5 These studies suggest that the incremental (that is, above the cost of continued conservative management) cost of lumbar discectomy, is between $5,200 and $12,500 US including ABSTRACT: Background: Outpatient surgery saves the risk of nosocomial complications and health care dollars. Patients undergoing lumbar microsurgical discectomy are excellent candidates for outpatient surgery.…”

mentioning

confidence: 99%

Outpatient Lumbar Microdiscectomy: A Prospective Study in 122 Patients

Singhal

Bernstein

2002

Can. j. neurol. sci.

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In this era of escalating health care costs and increasingly limited health care resources, there has been increased interest in restraining health care costs and maximizing the benefit of each dollar spent. It has been estimated that the direct medical costs of the over 200,000 lumbar discectomies performed annually in the United States, exceeds $5 billion US. [1][2][3] There has been an explosive growth in the field of costeffectiveness analysis. There is now an increasing body of literature dealing specifically with the cost-effectiveness of lumbar discectomy for the treatment of herniated intervertebral discs. 2,4,5 These studies suggest that the incremental (that is, above the cost of continued conservative management) cost of lumbar discectomy, is between $5,200 and $12,500 US including ABSTRACT: Background: Outpatient surgery saves the risk of nosocomial complications and health care dollars. Patients undergoing lumbar microsurgical discectomy are excellent candidates for outpatient surgery. The object of this study was to examine the feasibility of performing lumbar microdiscectomy on an outpatient protocol and to examine the potential savings associated with such a protocol. Methods: From February 1997 to September, 2001, 122 consecutive patients of the senior author were entered into a protocol of outpatient lumbar microdiscectomy. Only elective cases were considered for this study. Patients were excluded if they had significant co-morbidities, lived a significant distance out of town, or if their surgery was scheduled too late in the day. Success was defined as discharge home from the day-surgery unit approximately four hours after surgery. Results: During the study period, 150 elective lumbar microdiscectomies were performed. Twenty-four patients were excluded based on the above criteria and four patients requested not to participate in the study. Of the remaining 122, 116 successfully completed the protocol (95.1%). Six patients were admitted from the day surgery unit; two patients with dural tears and four patients with anaesthetic side-effects. No patient was readmitted to hospital after discharge and no complications of early discharge were observed. There was a total reduction in hospitalization of 1.2 nights per elective procedure considering the 150 patients, when compared with the hospitalization times prior to outpatient lumbar microdiscectomy. Conclusions: Lumbar microdiscectomy can be performed safely as an outpatient procedure, resulting in a substantial reduction in hospitalization times.RÉSUMÉ: La microdiscectomie lombaire ambulatoire: étude prospective de 122 patients. Introduction: La chirurgie ambulatoire diminue le risque de complications opportunistes et les coûts de santé. Les patients qui subissent une discectomie lombaire par microchirurgie sont d'excellents candidats à la chirurgie ambulatoire. Le but de cette étude était d'examiner la faisabilité d'un protocole de microdiscectomie lombaire effectuée en externe et la diminution des coûts associés. Méthodes: 122 patients consécu...

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“…요추는 다른 척추보다 체중을 지지하기 위해 수반 되는 긴장, 압박이 크고 운동범위가 넓어 손상과 변성의 기 회가 많기 때문에 인류의 80 % 이상이 요통을 경험한다 1) . 요추 추간판 탈출증이나 척추 협착증은 요통 및 하지 방사 통을 유발하는 대표적인 원인 질환으로 치료는 수술적 치 료나 보존적 치료로 나눌 수 있는데 2) , 보존적 치료로 80 % 이상이 호전되며 10 % 정도만 수술이 필요하다 3) . 이에 요 통 및 하지 방사통 환자의 보존적 치료에 대한 관심이 높아 지며, 한의학적인 치료법인 침, 뜸, 한약, 추나요법, 약침 요법, 도침요법 등에 관련한 임상 연구들이 보고되고 있다 4,5) .…”

Section: ⅰ 서 론unclassified

The Effect of Acupotomy on Lumbar Herniated Intervertebral Disc: Report of a Case Series

Kim

et al. 2015

The Acupuncture

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Objectives : This is a case series reporting of the improvement in patients with a lumbar herniated intervertebral disc by means of acupotomy combined with oriental medicine. Methods : We treated seven patients with a lumbar herniated intervertebral disc with acupotomy combined with oriental medical treatment. We checked the numeric rating scale(NRS), oswestry low back pain disability index(ODI) and range of motion(ROM). Results : NRS and ODI decreased, and ROM improved in all cases. Conclusions : This study shows acupotomy has a meaningful effect when applied on a lumbar herniated intervertebral disc.

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Cost-Effectiveness Analysis of Extended Conservative Therapy Versus Surgical Intervention in the Management of Herniated Lumbar Intervertebral Disc

Cited by 96 publications

References 0 publications

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

The clinical effectiveness and cost-effectiveness of management strategies for sciatica: systematic review and economic model

Outpatient Lumbar Microdiscectomy: A Prospective Study in 122 Patients

The Effect of Acupotomy on Lumbar Herniated Intervertebral Disc: Report of a Case Series

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