Document Detail

Histopathological examination of intervertebral disc specimens: a cost-benefit analysis.
MedLine Citation:
PMID:  18062454     Owner:  NLM     Status:  MEDLINE    
OBJECT: Routine histopathological examination of intervertebral disc specimens is commonly performed in North American hospitals, but recent studies have questioned the utility of this practice in cases where the indication for surgery is a benign process such as degenerative disc disease. In this study, we have performed a cost-benefit analysis of this practice. METHODS: We performed a cost-benefit analysis of routine histopathological examination of 1775 routine (non-neoplastic and non-infectious indications for surgery) and 70 non-routine (suspected neoplastic or infectious indications for surgery) discectomy specimens obtained over an eight-year period (1996 and 2004). Chart reviews were used to determine if any histopathology findings were clinically significant (i.e., affected subsequent patient care). Total costs were calculated. A literature review was conducted to compare our results with other published series. RESULTS: We found four unexpected histopathology results among 1775 specimens obtained from routine cases, one of which was clinically significant. We calculated costs of $42,165.25 per unexpected histopathological finding and $168,625 per clinically significant histopathological finding. For non-routine surgeries, the cost per abnormal pathological finding was $116.67. CONCLUSIONS: In routine cases, histopathological examination of disc specimens is not justified. The decision to send specimens for pathological examination should be based on the surgeon's judgment.
Adam S Wu; Daryl R Fourney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  34     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-07     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  451-5     Citation Subset:  IM    
Division of Neurosurgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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MeSH Terms
Cost-Benefit Analysis
Intervertebral Disk / pathology*,  surgery
Pathology, Surgical / economics*
Spinal Diseases / epidemiology*,  pathology,  surgery

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