This is the 4-year cost-effectiveness arm of SPORT. It compares surgery with nonoperative care for three well-defined lumbar diagnoses: spinal stenosis, degenerative spondylolisthesis, and disc herniation. Outcomes are measured as cost per quality-adjusted life year using patient-reported EQ-5D and resource data.
When counseling a patient with a well-defined lumbar diagnosis, this paper gives you the numbers to frame surgery as good economic value, not just symptom relief. Discectomy for disc herniation is the clear winner at roughly $20,600 per QALY, comfortably within accepted cost-effectiveness ranges.
Stenosis and spondylolisthesis surgery land near $59,000 and $64,000 per QALY at 4 years, still within the range of commonly accepted medical practices. A key teaching point: value improved with longer follow-up because health gains stayed durable while nonoperative patients kept accruing costs, especially lost productivity in spondylolisthesis.
Remember the scope limit. These results apply only to patients with clear surgical indications and cannot be generalized to degenerative disc disease or vague back pain.
This is the 4-year cost-effectiveness arm of SPORT. It compares surgery with nonoperative care for three well-defined lumbar diagnoses: spinal stenosis, degenerative spondylolisthesis, and disc herniation. Outcomes are measured as cost per quality-adjusted life year using patient-reported EQ-5D and resource data.
When counseling a patient with a well-defined lumbar diagnosis, this paper gives you the numbers to frame surgery as good economic value, not just symptom relief. Discectomy for disc herniation is the clear winner at roughly $20,600 per QALY, comfortably within accepted cost-effectiveness ranges.
Stenosis and spondylolisthesis surgery land near $59,000 and $64,000 per QALY at 4 years, still within the range of commonly accepted medical practices. A key teaching point: value improved with longer follow-up because health gains stayed durable while nonoperative patients kept accruing costs, especially lost productivity in spondylolisthesis.
Remember the scope limit. These results apply only to patients with clear surgical indications and cannot be generalized to degenerative disc disease or vague back pain.