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An Economic Evaluation of a Clinical Trial to Compare Automated Percutaneous Lumbar Discectomy With Microdiscectomy in the Treatment of Contained Lumbar Disc Herniation

Study Design A cost-effectiveness study of automated percutaneous lumbar discectomy (APLD) vs. microdiscectomy in the treatment of contained lumbar herniation in a randomized controlled trial. Objectives To quantify hospital costs and other public sector expenditure; to collect socioeconomic data that might bear on the recovery rate of patients and their private costs; and to relate costs to clinical outcomes. Summary of Background Data The authors are aware of no similar economic evaluation in this field. Methods The surgical procedures were costed from detailed lists of the time spent and resources used. Socioeconomic patient data were collected by questionnaires administered around the time of the of the operation and on follow-up at 6 months. Statistical analysis was by the chi-square method. Results There was no evidence that either procedure imposed significantly greater costs on patients or nonhospital medical services. Conclusion It was demonstrated that, within the restrictions imposed by the data set, automated percutaneous lumbar discectomy was less cost-effective than microdiscectomy.