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Surgery may not be cost-effective strategy for management of thoracolumbar burst fractures
In this register-based cohort study, researchers found surgical management for patients with traumatic thoracolumbar burst fractures without neurological deficits may not be as cost-effective as conservative care.
Researchers included 85 patients who had data available 2 years prior to trauma and 2 years after trauma. All patients had CT-verified AO type A3 fractures (T11-L2). The cost parameter defined primary and secondary health care use, and the effect parameter was based on three alternative measures of pain medication. The alternative measures were morphine milligrams, defined daily doses (DDD) of narcotic and non-narcotic analgesics.
The costs attributable to trauma were 7841 euros for conservative management and 21,266 euros for surgical management. Patients in the surgical group had a higher use of primary health care, which was almost three-fold higher than the conservative group, according to researchers.
The differences for morphine use at 527 milligrams, narcotic analgesics at –8 DDD and non-narcotic analgesics at –3 DDD were all insignificant.
“Our study showed that conservative management appeared to be a better choice in terms of cost-effectiveness for traumatic thoracolumbar burst fractures without neurological deficits from a health care sector perspective. However, a possible cost-effectiveness difference from a societal perspective will eventually be dependent on the time to return to work,” the researchers wrote in the study. – by Robert Linnehan
Disclosures: Aras reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.