A new study published in The Spine Journal examines the value of interspinous spacers for lumbar spinal stenosis treatment.
The study authors examined the Medicare Provider Analysis and Review database from 2005 to 2009 to gather data on patients 65 years and older with spinal stenosis. The patients included in the study had no previous spine surgeries or contraindications for decompression surgery. Patients either underwent conservative care, spacer surgery or decompression surgery. Researchers followed the patients for 10 years and found:
1. Patients who underwent the spacer procedures reported incremental cost-effectiveness ratios of $89,500 per quality-adjusted life year. The findings were under the $100,000 benchmark for cost-effectiveness as long as the reoperation rate wasn't above 54 percent.
2. Worst-case scenario, the researchers found incremental cost-effectiveness ratio was $482,000 per quality-adjusted life year for the spacer procedure.
3. Under the worst-case scenario, the spacer procedure ICER fell below the $100,000 per QALY benchmark if:
• The post-spacer utility was 0.01 greater than post-decompression utility
• Spacer cost was $1,600 less than decompression surgery
4. Spacer procedures could be reasonably cost-effective for spinal stenosis patients, according to study results. "Their value is expected to improve if procedure costs are lower in outpatient settings where these procedures are increasingly being done," according to the study authors.