Presentations How Cost Effective Are Spine Interventions? | Page 7

The 2‐Year Cost‐Effectiveness of 3 options to
Treat Lumbar Spinal Stenosis Patients
´ Abstract
´ Treatments for LSS range from conservative management including epidural steroid injections
(ESI) to laminectomy surgery.
´ Treatments vary greatly in cost and success.
´ ESI is the least costly treatment may be successful for early stages of LSS but often must be
repeated frequently.
´ Laminectomy surgery is more costly and has higher complication rates.
´ Minimally invasive lumbar decompression (mild ® ) is an alternative.
´ Using a decision‐analytic model from the Medicare perspective, a cost‐effectiveness analysis was
performed compar ing mild ® to ESI or laminectomy surgery. The analysis population included
patients with LSS who have moderate to severe symptoms and have failed conservative therapy.
Costs included initial procedure, complications, and repeat/revision or alternate procedure after
failure. Effects measured as change in quality‐adjusted life years (QALY) from pre-procedure to
2 years post-procedure. Incremental cost‐effectiveness ratios were determined, and sensitivity
analysis conducted. The mild ® strategy appears to be the most cost‐effective ($43,760/QALY),
with ESI the next best alternative at an additional $37,758/QALY. Laminectomy surgery was the
least cost‐effective ($125,985/QALY).