Health Economics Evaluation Of The PVP Minimal Invasive Surgery And Drugs Therapy In Osteoporotic Spinal Compression Fractures

Objective: To analyze the clinical efficacy and health economics of different treatment methods for patients with osteoporotic vertebral compression fractures(OVCF), to provide the theory basis and guide the implementation of the best cost- effective treatment for the clinician. Methods: 225 OVCF patients were divided into three groups according to different treatment options, 74 patients underwent PVP minimal invasive surgery, 82 patients underwent PVP minimal invasive surgery combined with zoledronicacid drug treatment, and 69 patients with conventional drugs. The Clinical efficacy and economic index of the three groups were compared, including compressed vertebral height loss rate, bone density value, visual analogue scale(VAS), the use score of analgesic drugs and spinal activity score in different periods before and after treatment, As well as the hospital stay, the total cost of hospitalization, rehabilitation expenses during hospitalization, and the cost of the recovery period after discharge. Correlation analysis were carried out between hospital stay, total cost of hospitalization, cost of rehabilitation period and the difference of the score of vertebral function, the X-ray image degree of vertebral compression fracture in the three groups of patients. Results: Hospitalization days of the PVP minimal invasive group was shortest, than that in the PVP group, hospitalization days of drug conservative group was longest(F=329.608, P<0.05).At 3 months and 12 months after treatment, the bone density, VAS score and the vertebral height loss rate of the three groups were statistically significant(P<0.05), the conservative group with the lowest bone density, VAS score and vertebral height loss rate were the highest. At 3 months after treatment, three groups patients with analgesic drug use score were reduced(F=146.580, 186.324, 135.110, P<0.05), PVP minimal invasive combined with zoledronicacid drug group was the lowest; In the three groups, the activity of spine were improved(F=282.872, 173.446, 313.856, P<0.05), PVP minimal invasive combined with zoledronicacid drug group was superior to the other two groups. The economic index analysis showed that the hospitalization expenses of the conservative group were the lowest, the rehabilitation expenses during hospitalization and the cost of the recovery period after discharge were highest(F=630.869, 796.695, 123.306, P<0.05). The hospital stay, total cost of hospitalization and expenses of rehabilitation period were positively correlated with the difference of the vertebral function score and X-ray imaging degree(P<0.05). In the other two groups, there was a positive correlation between the total cost of hospitalization and X-ray imaging degree(P < 0.05). Conclusion: Through cost-effectiveness analysis, PVP minimal invasive combined with zoledronicacid drug treatment of OVCF is the best method, but the economic cost is the highest, it’s suitable for patients with severe spinal compression fractures and better economic conditions. The cost-effectiveness of single PVP minimal invasive surgery is good, and can be applied to any degree of spinal compression fractures, which can be popularized in clinic. Although the cost of drug conservative treatment is lowest, but it’s effect is general, only suitable for patients with mild compression, or can’t tolerate minimal invasive surgery and economic conditions generally.