Evidence map›Paper›PMID 36934112›Full record

Observational studyScientific reports2023

Cost consequence analysis of waiting for lumbar disc herniation surgery.

Charlotte Dandurand, Mohammad Sadegh Mashayekhi, Greg McIntosh, Supriya Singh, Jerome Paquet, Hasaan Chaudhry, Edward Abraham, Christopher S Bailey, Michael H Weber, Michael G Johnson and 13 more

Full text readObservational Study
In one paragraph

Observational study in Scientific reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The effect of symptom duration on the outcomes of lumbar discectomy for radicular pain secondary to lumbar disc herniation: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025
    Pooled it
  2. Review
  3. Article
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Charlotte DandurandCombined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. charlotte.dandurand@vch.ca.
Mohammad Sadegh MashayekhiCombined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
Greg McIntoshCanadian Spine Outcomes and Research Network, Markdale, ON, Canada.
Supriya SinghLondon Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, ON, Canada.
Jerome PaquetCentre de Recherche CHU de Quebec, CHU de Quebec-Universite Laval, Quebec City, QC, Canada.
Hasaan ChaudhrySunnybrook Hospital, University of Toronto, Toronto, ON, Canada.
Edward AbrahamDivision of Orthopaedic Surgery, Zone 2, Horizon Health Network, Canada East Spine Centre, Saint John, NB, Canada.
Christopher S BaileyLondon Health Science Centre Combined Neurosurgical and Orthopaedic Spine Program, Schulich School of Medicine, Western University, London, ON, Canada.
Michael H WeberDepartment of Surgery, Division of Orthopaedics, Montreal General Hospital, McGill University, Montreal, QC, Canada.
Michael G JohnsonDepartment of Surgery, Section of Orthopedics and Neurosurgery, University of Manitoba, Winnipeg, MB, Canada.
Andrew NatarajDivision of Neurosurgery, University of Alberta, Edmonton, AB, Canada.
Najmedden AttabibDivision of Neurosurgery, Zone 2, Horizon Health Network, Canada East Spine Centre, Saint John, NB, Canada.
Adrienne KellySault Area Hospital, Northern Ontario School of Medicine, Sault Ste Marie, ON, Canada.
Hamilton HallDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Y Raja RampersaudSchroeder Arthritis Institute, Krembil Research Institute, University Health Network, Orthopaedics, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Neil MansonDivision of Orthopaedic Surgery, Zone 2, Horizon Health Network, Canada East Spine Centre, Saint John, NB, Canada.
Philippe PhanDivision of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital, Ottawa, ON, Canada.
Ken ThomasUniversity of Calgary Spine Program, University of Calgary, Calgary, AB, Canada.
Charles FisherCombined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
Raphaele Charest-MorinCombined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
Alex SoroceanuDivision of Orthopaedic Surgery, University of Ottawa, Ottawa Hospital, Ottawa, ON, Canada.
Bernard LaRueDépartment de chirurgie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada.
Nicolas DeaCombined Neurosurgical and Orthopedic Spine Program, Department of Orthopedics Surgery, University of British Columbia, Blusson Spinal Cord Center, 6th Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The economic repercussions of waiting for lumbar disc surgery have not been well studied. The primary goal of this study was to perform a cost-consequence analysis of patients receiving early vs late surgery for symptomatic disc herniation from a societal perspective. Secondarily, we compared patient factors and patient-reported outcomes. This is a retrospective analysis of prospectively collected data from the CSORN registry. A cost-consequence analysis was performed where direct and indirect costs were compared, and different outcomes were listed separately. Comparisons were made on an observational cohort of patients receiving surgery less than 60 days after consent (short wait) or 60 days or more after consent (long wait). This study included 493 patients with surgery between January 2015 and October 2021 with 272 patients (55.2%) in the short wait group and 221 patients (44.8%) classified as long wait. There was no difference in proportions of patients who returned to work at 3 and 12-months. Time from surgery to return to work was similar between both groups (34.0 vs 34.9 days, p = 0.804). Time from consent to return to work was longer in the longer wait group corresponding to an additional $11,753.10 mean indirect cost per patient. The short wait group showed increased healthcare usage at 3 months with more emergency department visits (52.6% vs 25.0%, p < 0.032), more physiotherapy (84.6% vs 72.0%, p < 0.001) and more MRI (65.2% vs 41.4%, p < 0.043). This corresponded to an additional direct cost of $518.21 per patient. Secondarily, the short wait group had higher baseline NRS leg, ODI, and lower EQ5D and PCS. The long wait group had more patients with symptoms over 2 years duration (57.6% vs 34.1%, p < 0.001). A higher proportion of patients reached MCID in terms of NRS leg pain at 3-month follow up in the short wait group (84.0% vs 75.9%, p < 0.040). This cost-consequence analysis of an observational cohort showed decreased costs associated with early surgery of $11,234.89 per patient when compared to late surgery for lumbar disc herniation. The early surgery group had more severe symptoms with higher healthcare utilization. This is counterbalanced by the additional productivity loss in the long wait group, which likely have a more chronic disease. From a societal economic perspective, early surgery seems beneficial and should be promoted.

Indexed as

Intervertebral Disc DisplacementCosts and Cost AnalysisHumansLumbar VertebraeLumbosacral RegionRetrospective StudiesTimeTreatment Outcome

Identifiers

PMID36934112
PMCPMC10024748

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read48
Read underepoch 390

Registered trials

None linked

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.