SynthesisClinical orthopaedics and related research2012
Value-based care in the management of spinal disorders: a systematic review of cost-utility analysis.
Synthesis in Clinical orthopaedics and related research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- The VBHC big picture: an umbrella review.BMC health services research · 2025Pooled it
- Management of low back pain and lumbosacral radicular syndrome: the Guideline of the Royal Dutch Society for Physical Therapy (KNGF).European journal of physical and rehabilitation medicine · 2024Guideline
- The McKenzie method for (sub)acute non-specific low back pain.The Cochrane database of systematic reviews · 2023Pooled it
- Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.International journal of medical sciences · 2017Trial
- Trial
- Article
- Trends and Themes in the Study of Value in Orthopedic Surgery: A Systematic Review.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025Review
- Effects of different treatments on pain, functional disability, position sense and range of motion in elite bodybuilders with chronic low back pain.Scientific reports · 2024Article
- Lumbo-Pelvic Rhythm Monitoring Using Wearable Technology with Sensory Biofeedback: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- The 5-item modified frailty index predicts spinal osteotomy outcomes better than age in adult spinal deformity patients: an ACS - NSQIP analysis.Spine deformity · 2023Article
- Decompression Alone in the Setting of Adult Degenerative Lumbar Scoliosis and Stenosis: A Systematic Review and Meta-Analysis.Global spine journal · 2023Article
- Does Baseline Mental Health Influence Outcomes among Workers' Compensation Claimants Undergoing Minimally Invasive Transforaminal Lumbar Interbody Fusion?Asian spine journal · 2023Article
- Predictive Analysis of Healthcare Resource Utilization after Elective Spine Surgery.Spine surgery and related research · 2022Article
- The Effect of a Multidisciplinary Spine Clinic on Time to Care in Patients with Chronic Back and/or Leg Pain: A Propensity Score-Matched Analysis.Journal of clinical medicine · 2022Article
- The burden of non-specific chronic low back pain among adults in KwaZulu-Natal, South Africa: a protocol for a mixed-methods study.BMJ open · 2020Article
- Cost Analysis of Single-Level Lumbar Fusions.Global spine journal · 2020Article
- Evaluation of Cost-Utility of Thoracic Interlaminar Epidural Injections.Current pain and headache reports · 2020Article
- Effects of aerobic exercise on pain and disability in patients with non-specific chronic low back pain: a systematic review protocol.Systematic reviews · 2019Article
- Randomized controlled trial of a 12-week digital care program in improving low back pain.NPJ digital medicine · 2019Article
- Treatment Efficacy, Clinical Utility, and Cost-Effectiveness of Multidisciplinary Biopsychosocial Rehabilitation Treatments for Persistent Low Back Pain: A Systematic Review.Global spine journal · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSpinal disorders are a major cause of disability and compromise in health-related quality of life. The direct and indirect costs of treating spinal disorders are estimated at more than $100 billion per year. With limited resources, the cost-utility of interventions is important for allocating resources. QUESTIONS/PURPOSES: We therefore performed a systematic review of the literature on cost-utility for nonoperative and operative interventions for treating spinal disorders.
methodsWe searched four databases for cost-utility analysis studies on low back pain management and identified 1004 items. The titles and abstracts of 752 were screened before selecting 27 studies for inclusion; full texts of these 27 studies were individually evaluated by five individuals.
resultsStudies of nonoperative treatments demonstrated greater value for graded activity over physical therapy and pain management; spinal manipulation over exercise; behavioral therapy and physiotherapy over advice; and acupuncture and exercise over usual general practitioner care. Circumferential fusion and femoral ring allograft had greater value than posterolateral fusion and titanium cage, respectively. The relative cost-utility of operative versus nonoperative interventions was variable with the most consistent evidence indicating superior value of operative care for treating spinal disorders involving nerve compression and instability.
conclusionThe literature on cost-utility for treating spinal disorders is limited. Studies addressing cost-utility of nonoperative and operative management of low back pain encompass a broad spectrum of diagnoses and direct comparison of treatments based on cost-utility thresholds for comparative effectiveness is limited by diversity among disorders and methods to assess cost-utility. Future research will benefit from uniform methods and comparison of treatments in cohorts with well-defined pathology.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.