Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study
Issued Date
2023-01-01
Resource Type
eISSN
24689009
Scopus ID
2-s2.0-85178320787
Journal Title
Laparoscopic, Endoscopic, and Robotic Surgery
Rights Holder(s)
SCOPUS
Bibliographic Citation
Laparoscopic, Endoscopic, and Robotic Surgery (2023)
Suggested Citation
Chumnanvej S., Ariyaprakai K., Pillai B.M., Suthakorn J., Gurusamy S., Chumnanvej S. Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study. Laparoscopic, Endoscopic, and Robotic Surgery (2023). doi:10.1016/j.lers.2023.11.004 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91424
Title
Cost-effectiveness of robotic-assisted spinal surgery: A single-center retrospective study
Other Contributor(s)
Abstract
Objective: Robotic-assisted spine surgeries (RASS) have been shown to enhance precision, reduce operative time, prevent complications, facilitate minimally invasive spinal surgery, and decrease revision surgery rates, leading to improved patient outcomes. This study aimed to compare the cost-effectiveness of RASS and non-robotic-assisted surgery for degenerative spine disease at a single center. Methods: This retrospective study, including 122 patients, was conducted at a single center from March 2015 to February 2022. Patients who underwent robot-assisted surgery were assigned to the robot group, and patients who underwent non-robotic-assisted surgery were assigned to the non-robot group. Various data, including demographic information, surgical details, outcomes, and cost-effectiveness, were collected for both groups. The cost-effectiveness was determined using the incremental cost-effectiveness ratio (ICER), and subgroup analysis was conducted for patients with 1 or 2 levels of spinal instrumentation. The analysis was performed using STATA SE version 15 and TreeAge Pro 2020, with Monte Carlo simulations for the cost-effectiveness acceptability curve. Results: The overall ICER was $22,572, but it decreased to $16,980 when considering cases with only 1 or 2 levels of instrumentation. RASS is deemed cost-effective when the willingness to pay is $3000–$4000 if less than 2 levels of the spine are instrumented. Conclusions: The cost-effectiveness of robotic assistance becomes apparent when there is a reduced need for open surgeries, leading to decreased revision rates caused by complications such as misplaced screws or infections. Therefore, it is advisable to allocate healthcare budget resources to spine robots, as RASS proves to be cost-effective, particularly when only two or fewer spinal levels require instrumentation.