caa a22 4500 445832010 CHVBK 20180317145318.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-010-1607-3 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1607-3 Cost effectiveness of disc prosthesis versus lumbar fusion in patients with chronic low back pain: randomized controlled trial with 2-year follow-up [Elektronische Daten] [Peter Fritzell, Svante Berg, Fredrik Borgström, Tycho Tullberg, Hans Tropp] This randomized controlled health economic study assesses the cost-effectiveness of the concept of total disc replacement (TDR) (Charité/Prodisc/Maverick) when compared with the concept of instrumented lumbar fusion (FUS) [posterior lumbar fusion (PLF) /posterior lumbar interbody fusion (PLIF)]. Social and healthcare perspectives after 2years are reported. In all, 152 patients were randomized to either TDR (n=80) or lumbar FUS (n=72). Cost to society (total mean cost/patient, Swedish kronor=SEK, standard deviation) for TDR was SEK 599,560 (400,272), and for lumbar FUS SEK 685,919 (422,903) (ns). The difference was not significant: SEK 86,359 (−45,605 to 214,332). TDR was significantly less costly from a healthcare perspective, SEK 22,996 (1,202 to 43,055). Number of days on sick leave among those who returned to work was 185 (146) in the TDR group, and 252 (189) in the FUS group (ns). Using EQ-5D, the total gain in quality adjusted life years (QALYs) over 2years was 0.41 units for TDR and 0.40 units for FUS (ns). Based on EQ-5D, the incremental cost-effectiveness ratio (ICER) of using TDR instead of FUS was difficult to analyze due to the "non-difference” in treatment outcome, which is why cost/QALY was not meaningful to define. Using cost-effectiveness probabilistic analysis, the net benefit (with CI) was found to be SEK 91,359 (−73,643 to 249,114) (ns). We used the currency of 2006 where 1 EURO=9.26 SEK and 1 USD=7.38 SEK. It was not possible to state whether TDR or FUS is more cost-effective after 2years. Since disc replacement and lumbar fusion are based on different conceptual approaches, it is important to follow these results over time. The Author(s), 2010 Disc prosthesis nationallicence Lumbar fusion nationallicence Cost-effectiveness nationallicence Cost-utility nationallicence Health economic evaluation nationallicence Fritzell Peter Department of Orthopedic Surgery, Center for Clinical Research, Falun Hospital, Dalarna, Nissers Väg 3, SE-79182, Falun, Sweden aut Berg Svante Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, SE-19489, Stockholm, Sweden aut Borgström Fredrik i3 Innovus, Klarabergsviadukten 90 D, SE-111 64, Stockholm, Sweden aut Tullberg Tycho Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, SE-19489, Stockholm, Sweden aut Tropp Hans Department of Orthopedic Surgery, University Hospital, SE-58183, Linköping, Sweden aut European Spine Journal Springer-Verlag 20/7(2011-07-01), 1001-1011 0940-6719 20:7<1001 2011 20 586 https://doi.org/10.1007/s00586-010-1607-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1607-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fritzell Peter Department of Orthopedic Surgery, Center for Clinical Research, Falun Hospital, Dalarna, Nissers Väg 3, SE-79182, Falun, Sweden aut NATIONALLICENCE 700 1- Berg Svante Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, SE-19489, Stockholm, Sweden aut NATIONALLICENCE 700 1- Borgström Fredrik i3 Innovus, Klarabergsviadukten 90 D, SE-111 64, Stockholm, Sweden aut NATIONALLICENCE 700 1- Tullberg Tycho Stockholm Spine Center, Löwenströmska Hospital, Upplands Väsby, SE-19489, Stockholm, Sweden aut NATIONALLICENCE 700 1- Tropp Hans Department of Orthopedic Surgery, University Hospital, SE-58183, Linköping, Sweden aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20/7(2011-07-01), 1001-1011 0940-6719 20:7<1001 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer