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A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis

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Abstract

Purpose

The purpose of this study was to compare patient-reported outcomes (PROs), morbidity, and costs of TLIF vs PLF to determine whether one treatment was superior in the setting of single-level degenerative spondylolisthesis.

Methods

Patients undergoing TLIF or PLF for single-level spondylolisthesis were included for retrospective analysis. EQ-5D, ODI, SF-12 MCS/PCS, NRS-BP/LP scores were collected at baseline and 24 months after surgery. 90-day post-operative complications, revision surgery rates, and satisfaction scores were also collected. Two-year resource use was multiplied by unit costs based on Medicare payment amounts (direct cost). Patient and caregiver workday losses were multiplied by the self-reported gross-of-tax wage rate (indirect cost). Total cost was used to assess mean total 2-year cost per QALYs gained after surgery.

Results

62 and 37 patients underwent TLIF and PLF, respectively. Patients in the PLF group were older (p < 0.01). No significant differences were seen in baseline or 24-month PROs between the two groups. There was a significant improvement in all PROs from baseline to 24 months after surgery (p < 0.001). Both groups had similar rates of 90-day complications, revision surgery, satisfaction, and similar gain in QALYs and cost per QALYs gained. There was no significant difference in 24-month direct, indirect, and total cost.

Conclusions

Overall costs and health care utilization were similar in both the groups. Both TLIF and PLF for single-level degenerative spondylolisthesis provide improvement in disability, pain, quality of life, and general health.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Vanderbilt Spine Institute, Vanderbilt University School of Medicine, Medical Center East, South Tower, Suite 4200, Nashville, TN, 37232-8774, USA

    Elliott Kim, Silky Chotai, David Stonko, Joseph Wick, Alex Sielatycki & Clinton J. Devin

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  1. Elliott Kim
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  2. Silky Chotai
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Correspondence to Clinton J. Devin.

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There are no conflicts of interest to disclose and no outside sources of funding were received for this study. This study was approved by the institutional review board (IRB). The manuscript submitted does not contain information about medical device(s)/drug(s).

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Kim, E., Chotai, S., Stonko, D. et al. A retrospective review comparing two-year patient-reported outcomes, costs, and healthcare resource utilization for TLIF vs. PLF for single-level degenerative spondylolisthesis. Eur Spine J 27, 661–669 (2018). https://doi.org/10.1007/s00586-017-5142-3

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  • DOI: https://doi.org/10.1007/s00586-017-5142-3

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