| アブストラクト | PURPOSE: To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery-commonly known as Failed Back Surgery Syndrome-and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy. METHODS: The UK population-based healthcare data from the Hospital Episode Statistics (HES) database from NHS Digital and the Clinical Practice Research Datalink (CPRD) were queried to identify patients with PPP following lumbar spinal surgery. Rates of PPP were calculated by type of surgery (instrumented and non-instrumented). Total healthcare costs associated with the surgery and covering the 24-month period after index hospital discharge were estimated using standard methods for classifying health care encounters into major categories of health care resource utilization (i.e., inpatient hospital stays, outpatient clinic visits, accident and emergency attendances, primary care encounters, and medications prescribed in primary care) and applying the appropriate unit costs (expressed in 2013 GBP). RESULTS: Increasing the complexity of surgery with instrumentation was not associated with an increased rate of PPP. However, 2-year healthcare costs following discharge after surgery are significantly higher among patients who underwent instrumented surgery compared with decompression/discectomy. CONCLUSIONS: Although there is a not insubstantial risk of ongoing pain following spine surgery, with 1-in-5 patients experiencing PPP within 2 years of surgery, the underlying indications for surgical modality and related choice of surgical procedure do not, by itself, appear to be a driving factor. |
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| 投稿者 | Weir, Sharada; Samnaliev, Mihail; Kuo, Tzu-Chun; Tierney, Travis S; Manca, Andrea; Taylor, Rod S; Bruce, Julie; Eldabe, Sam; Cumming, David |
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| 組織名 | PHMR, Ltd., Bldg D, Berkeley Works, Berkley Grove, London, NW1 8XY, UK.;sharadaweir@phmr.com.;Harvard Medical School, Boston Children's Hospital, 300 Longwood Ave, Boston, MA,;02115, USA.;Centre for Neuroinflammation and Neurodegeneration, Division of Brain Sciences,;Department of Medicine, Imperial College, Du Cane Road, London, W120NN, UK.;Centre for Health Economics, Alcuin A, University of York, York, YO10 5DD, UK.;Institute of Health Research, University of Exeter Medical School, South;Cloisters, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.;Warwick Clinical Trials Unit, Division of Health Sciences, Warwick Medical;School, University of Warwick, Coventry, CV4 7AL, UK.;Department of Pain Medicine, Cheriton House, The James Cook University Hospital,;Marton Road, Middlesbrough, BW, TS4 3, UK.;Trauma and Orthopaedics Department, Ipswich Hospital, Heath Road, Ipswich,;Suffolk, IP4 5PD, UK. |
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