{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T13:54:09Z","timestamp":1791899649814,"version":"4.3.4"},"reference-count":59,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,3,26]],"date-time":"2014-03-26T00:00:00Z","timestamp":1395792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The increase in the number of interventions for the management of chronic pain and associated escalation of healthcare costs has captured the attention of health policymakers, in no small part due to the lack of documentation of efficacy, cost\u2010effectiveness, or cost utility analysis. A recent cost utility analysis of caudal epidural injections in managing chronic low back pain of various pathologies showed a high cost utility with improvement in quality of life years, competitive with various other modalities of treatments. However, there are no analyses derived from high\u2010quality controlled studies related to the cost utility of percutaneous adhesiolysis in the treatment of post\u2010lumbar surgery syndrome or lumbar central spinal stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>This analysis is based on 2 previously published controlled studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the cost utility of percutaneous adhesiolysis procedures in managing chronic low back and lower extremity pain secondary to post\u2010lumbar surgery syndrome and lumbar central spinal stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>A private, specialty referral interventional pain management center in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two controlled studies were conducted assessing the clinical effectiveness of percutaneous adhesiolysis for post\u2010lumbar surgery syndrome and lumbar central spinal stenosis in an interventional pain management setting utilizing contemporary interventional pain management practices. A cost utility analysis was performed with direct payment data for a total of 130 patients in treatment groups over a 2\u2010year period. Various outcome measures were included with significant improvement, defined as at least 50% improvement with reduction in pain and disability status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The results of 2 controlled studies of low back pain with 60 and 70 patients and a 2\u2010year follow\u2010up with the actual reimbursement data showed cost utility for 1\u00a0year of quality\u2010adjusted life year (<jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>) of <jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content> $2,652 for post\u2010lumbar surgery syndrome and <jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content> $2,649 for lumbar central spinal stenosis. The results of this assessment show that the cost utility of managing chronic, intractable low back pain with percutaneous adhesiolysis at a <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content> that is similar or lower in price than medical therapy only, physical therapy, manipulation, spinal cord stimulation, and surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Limitations<\/jats:title><jats:p>The limitations of this cost utility analysis are that it is a single\u2010center evaluation, with the inclusion of costs of adhesiolysis procedures in an ambulatory surgery center and physician visits, rather than all related costs including drug therapy and costs of disability in multiple settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This cost utility analysis of percutaneous adhesiolysis in the treatment of post\u2010lumbar surgery syndrome and lumbar central spinal stenosis shows the clinical effectiveness and cost utility of these procedures at <jats:styled-content style=\"fixed-case\">USD<\/jats:styled-content> $2,650 per one year of <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content> when performed in an ambulatory surgery center.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12195","type":"journal-article","created":{"date-parts":[[2014,3,26]],"date-time":"2014-03-26T06:06:43Z","timestamp":1395814003000},"page":"414-422","source":"Crossref","is-referenced-by-count":24,"title":["Cost Utility Analysis of Percutaneous Adhesiolysis in Managing Pain of Post\u2010lumbar Surgery Syndrome and Lumbar Central Spinal Stenosis"],"prefix":"10.1111","volume":"15","author":[{"given":"Laxmaiah","family":"Manchikanti","sequence":"first","affiliation":[{"name":"Pain Management Center of Paducah Paducah Kentucky U.S.A"},{"name":"Anesthesiology and Perioperative Medicine University of Louisville Louisville Kentucky 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