Hello, I am Gurpreet Gandhok, presenting our work on studying the cost-effectiveness of an autograft harvesting technology in adult lumbar spine surgery. We asked two questions. 1. Does harvested autograft help reduce cost despite the cost of the harvesting device? 2. How does utilizing autograft impact quality of life of the patient? This picture depicts the design of the autograft harvesting device and the self-cohesive, malleable nature of the collected bone. This, in turn, can be easily delivered back to the patient with the plunging action of a syringe. This slide depicts the decision tree. For 81 out of 107 patients, the bone collector was used and for 26, it was not. We calculated the cost of the allograft used in both groups. The effectiveness for each group was calculated with quality-adjusted life years gained at 2 years. This table depicts the cost and probabilities studied for the base case calculations and the ranges that we applied to calculate the sensitivity analyses. This table depicts the different allografts used in our patients and their costs, which range from $200 to $5,000 based on the quantity and the product used. This slide depicts the cost-effectiveness ranking calculations from the base case scenario revealed that using the bone collector was cost-saving and more effective, saving $325 and gaining 0.04 quality-adjusted life years. One-way sensitivity analyses depicted in this tornado diagram reveal the cost of the bone collector to be the most impactful variable to the question in study. The cost threshold until the bone collector remained cost-effective was around $2,900. In this two-way sensitivity analyses varying the quality-adjusted life years and the cost of the bone collector, we found that a bone collector costing less than $1,050 remained the cost-effective strategy no matter how high a quality-adjusted life year it was pitched against. In another two-way sensitivity analyses presuming equivalent utilities between the two groups, it was found that using the bone collector was cost-effective if the allograft cost more than $1,160. Our results remained robust through multiple sensitivity analyses. Using the bone collector remained the dominant strategy unless the cost was more than $2,900. The question for the audience is a true or false statement. Autograft harvested with a bone collecting device from the patient while drilling bone for decompression during lumbar spine surgery is a cost-effective strategy.

autograft harvesting technology

adult lumbar spine surgery

cost-effectiveness

bone collector

patient's quality of life