Cost-utility Analysis-Comparison between with and without using Intraoperative Neuromonitoring in Spinal Surgery for Adolescent Idiopathic Scoliosis Patients
Author(s): Chaiwat Lorphongphaiboon, Anand Sachamuneewongse, Thanita Panya-amornwat, Athikom Methathien, Yongyot Laungwitchajareon, Sukrom Cheecharern
Introduction: Nowadays, Intraoperative Neuromonitoring (IONM) techniques are used in complex spinal surgery to improve surgical outcome by reducing the risk of iatrogenic neural injury. But the cost of the device does not included by National Heath Security Care system of Thailand.
Objective: To compare cost-utility between with and without using IONM in spinal surgery for Adolescent Idiopathic Scoliosis (AIS) patients.
Methods: A retrospective review of prospectively collected data in 40 Adolescent Idiopathic Scoliosis patients after 6 months post operation at Rajavithi hospital. EQ-5D-5L (Thai version) questionnaires and medical record review were administered.
Results: Conventional surgery cost 681,746.57 Baht or $ 20,647.10 more than surgery with IONM (Conventional surgery 1,061,405.75 Baht or $ 32,145.30, using IONM 379,659.18 Baht or $11,498.20). The quality-adjusted life years (QALYs) in conventional surgery was 0.878 and is surgery with IONM was 0.9.
Conclusion: Spinal surgery with using IONM in AIS patients is cost-effective strategy than conventional surgery.