Abstract | STUDY DESIGN: Prospective cohort study. OBJECTIVES: To perform a cost-utility analysis and to investigate the clinical outcomes and patient's quality of life after anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis compared between fusion with polyetheretherketone ( PEEK) and fusion with tricortical iliac bone graft (IBG) in Thailand. SUMMARY OF BACKGROUND DATA: ACDF is one of the standard treatments for cervical spondylosis. The fusion material options include PEEK and tricortical IBG. No previous studies have compared the cost-utility between these 2 fusion material options. PATIENTS AND METHODS: Patients with cervical spondylosis who were scheduled for ACDF at Siriraj Hospital (Bangkok, Thailand) during 2019-2020 were prospectively enrolled. Patients were allocated to the PEEK or IBG fusion material group according to the patient's choice of fusion material. EuroQol-5 dimensions 5 levels and relevant costs were collected during the operative and postoperative periods. A cost-utility analysis was performed using a societal perspective. All costs were converted to 2020 United States dollars (USD), and a 3% discount rate was used. The outcome was expressed as the incremental cost-effectiveness ratio. RESULTS: Thirty-six patients (18 ACDF- PEEK and 18 ACDF-IBG) were enrolled. Except for Nurick grading, there was no significant difference in patient baseline characteristics between groups. The average utility at 1 year after ACDF- PEEK and ACDF-IBG were 0.939 ± 0.061 and 0.798 ± 0.081, respectively ( P < 0.001). The total lifetime cost of ACDF- PEEK and ACDF-IBG was 83,572 USD and 73,329 USD, respectively. The incremental cost-effectiveness ratio of ACDF- PEEK when compared with that of ACDF-IBG showed a gain of 4468.52 USD/quality-adjusted life-years, which is considered cost-effective at the Thailand willingness-to-pay threshold of 5115 USD/quality-adjusted life-year gained. CONCLUSIONS: LEVEL OF EVIDENCE: Level II.
|
Authors | Muhammadakbar Hajeeyeh, Sirichai Wilartratsami, Pochamana Phisalprapa, Urawit Piyapromdee, Tuanrit Sornsa-Ard, Chayanis Kositamongkol, Visit Vamvanij, Panya Luksanapruksa |
Journal | Clinical spine surgery
(Clin Spine Surg)
Vol. 36
Issue 8
Pg. E353-E361
(10 01 2023)
ISSN: 2380-0194 [Electronic] United States |
PMID | 37296495
(Publication Type: Journal Article)
|
Copyright | Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. |
Chemical References |
- polyetheretherketone
- Polyethylene Glycols
- Ketones
|
Topics |
- Humans
- Cost-Benefit Analysis
- Ilium
(surgery)
- Prospective Studies
- Quality of Life
- Treatment Outcome
- Thailand
- Polyethylene Glycols
(therapeutic use)
- Ketones
(therapeutic use)
- Diskectomy
(methods)
- Spondylosis
(surgery)
- Cervical Vertebrae
(surgery)
- Spinal Fusion
(methods)
- Retrospective Studies
|