Cost Effectiveness Of The Surgical Treatments For Tn

813 Words Oct 17th, 2015 4 Pages
Several studies have compared the cost effectiveness of the surgical treatments for TN. Both Holland et al(57) and Pollock et al(5) conducted small studies in which they found that MVD produced a higher number of quality-adjusted pain free years and was more cost effective than SRS. In Holland’s study, while radiofrequency rhizotomy was found to be the most cost effective treatment, 74% of patients experienced a recurrence in pain. Sivakanthan et al(24) found that MVD produced a QALY gain of 8.2 at 5 year follow-up while SRS was 4.9 QALYs gained. With MVD at 6.0 and SRS at 5.4, our study demonstrated a smaller discrepancy in QALYs gained than Sivakanthan. However, Sivakanthan’s study only used one article each to calculate the QALYs for the treatments. Spatz et al performed a decision analysis in 2007 comparing medical therapy, MVD, percutaneous glycerol rhizolysis, radiofrequency thermocoagulation, and balloon compression, using a cohort of 156 patients (58). They concluded that MVD was the procedure most likely to maximize QOL, however SRS was not included as a treatment modality.
Two studies have looked at the impact of MVD and SRS on patient satisfaction. Linskey et al found that at a follow-up of 3.9-8.5 years, all patients would undergo MVD again, but only 75% of patients would undergo SRS(18). Pain recurrence was cited as the major factor for dissatisfaction with SRS surgery. Nanda et al found that a trend towards higher patient satisfaction with MVD than SRS, but…
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