000			02783nam a22003737a 4500
008			191010s20132013 xxu||||| |||| 00| 0 eng d
022			_a2152-7806
024			_a10.4103/2152-7806.109444 [doi]
024			_aPMC3642749 [pmc]
024			_aSNI-4-67 [pii]
040			_aOvid MEDLINE(R)
099			_a23646277
245			_aTransforaminal lumbar interbody fusion and posterior lumbar interbody fusion utilizing BMP-2 in treatment of degenerative spondylolisthesis: neither safe nor cost effective.
251			_aSurgical neurology international. 4(Suppl 2):S67-73, 2013.
252			_aSurg Neurol Int. 4(Suppl 2):S67-73, 2013.
253			_aSurgical neurology international
260			_c2013
260			_fFY2013
265			_sepublish
266			_d2019-10-10
520			_aBACKGROUND: With the rise of health care costs, there is increased emphasis on evaluating the cost of a particular surgical procedure for quality adjusted life year (QALY) gained. Recent data have shown that surgical intervention for the treatment of degenerative spondylolisthesis (DS) is as cost-effective as total joint arthroplasty. Despite these excellent outcomes, some argue that the addition of interbody fusion supplemented with bone morphogenetic protein (BMP) enhances the value of this procedure.
520			_aCONCLUSIONS: To enhance the value of the surgical management for DS, costs must decrease or there should be substantial improvement in effectiveness as measured by clinical outcomes. To date, there is insufficient evidence to support the use of interbody fusion devices along with BMP to treat routine cases of focal stenosis accompanied by DS, which are routinely adequately treated utilizing posterolateral fusion techniques.
520			_aMETHODS: This review examines the current research regarding the cost-effectiveness of the surgical management of lumbar DS utilizing interbody fusion along with BMP.
520			_aRESULTS: Posterolateral spinal fusion with instrumentation for focal lumbar spinal stenosis with DS can provide and maintain improvement in self-reported quality of life. Based on the available literature, including nonrandomized comparative studies and case series, the addition of interbody fusion along with BMP does not lead to significantly better clinical outcomes and increases costs when compared with more routine posterolateral fusion techniques.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedstar Union Memorial Hospital
657			_aJournal Article
700			_aMoatz, Bradley
700			_aTortolani, P Justin
790			_aMoatz B, Tortolani PJ
856			_uhttps://dx.doi.org/10.4103/2152-7806.109444 _zhttps://dx.doi.org/10.4103/2152-7806.109444
942			_cART _dArticle
999			_c4625 _d4625