Cost-effectiveness of minimally invasive surgery for grade 1 lumbar spondylolisthesis: a 5-year Quality Outcomes Database study.
Minimally invasive surgery for grade 1 spondylolisthesis cost less per quality-adjusted life years gained than open surgery over 5 years
Cost-effectiveness of minimally invasive surgery for grade 1 lumbar spondylolisthesis: a 5-year Quality Outcomes Database study.
Minimally invasive surgery (minimally invasive surgery) is a reasonable treatment option for lumbar spondylolisthesis, but its long-term cost-effectiveness is not well established.
From the Spine COReTM study group's multicenter, prospectively collected Quality Outcomes Database grade 1 lumbar spondylolisthesis dataset who had undergone single-stage posterior surgery were included.
Of the 608 patients identified as having undergone single- or multiple-stage surgery, 559 underwent single-stage posterior surgery, 242 via minimally invasive surgery (mean age 64.3 ± 11.7 years, 71.1% arthrodesis rate) and 317 via open surgical approaches (mean age 61.3 ± 12.2 years, 78.5% arthrodesis rate).
The mean cost of minimally invasive surgery was significantly lower ($31,822) than that of open surgery ($39,151; p = 0.001).
Among those who underwent arthrodesis, the mean cost was $41,916 for minimally invasive surgery versus $46,626 for open surgery (p = 0.031).
Minimally invasive surgery for grade 1 lumbar spondylolisthesis demonstrated a 60-month cost per quality-adjusted life years gained of $29,995, which was significantly lower than open surgery's $41,635.
Differences were driven by LOS, complications, and reoperations, and minimally invasive surgery remained more cost-effective even after stratification for arthrodesis.
However, both surgical approaches remained below the $100,000 willingness-to-pay threshold, highlighting overall long-term cost-effectiveness.