Transforaminal lumbar interbody fusion (TLIF) and lateral lumbar interbody fusion (LLIF) both are cost-effective procedures that provide high quality-adjusted life years and similarly positive outcomes up to two years after surgery, study data show.
Gurpeet S. Gandhoke, M.D., chief neurosurgery resident at the University of Pittsburgh (Pa.) and his colleagues evaluated the difference between the cost-effectiveness ratio and quality-adjusted life years between the two procedures.
“Effectively, based on the data I got, I concluded that both TLIF and LLIF produced equal two-year patient outcomes and equal cost-effectiveness profiles. The level of improvement in the patient-reported outcomes, which was deemed fit by a patient who qualified as achieving a meaningful improvement, was always less than the extent of improvement that the patient expected for cost involved,” Gandhoke said.
The study included 45 patients who underwent a single level transforaminal lumbar interbody fusion and 29 who underwent a single-level standalone lateral lumbar interbody fusion. Two years after surgery, there was no statistically significant difference between the two surgical groups in SF-36 Physical Component scores, Oswesty Disability Index scores, VAS back pain scores, VAS leg pain scores and EQ5D scores. The median cost of an LLIF was about $45,574 --- which was not significantly different (statistically) --- than the $44,068 median cost of a TLIF, he noted.
Gandhoke said the cumulative quality-adjusted life years also was similar between the two groups (0.67 for TLIF and 0.60 for LLIF; P = .331).