{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:42:35Z","timestamp":1783593755889,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,7,5]],"date-time":"2017-07-05T00:00:00Z","timestamp":1499212800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous laser disc decompression (PLDD) for patients with lumbar disc herniation is believed to be cheaper than surgery. However, cost-effectiveness has never been studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A cost utility analysis was performed alongside a randomized controlled trial comparing PLDD and conventional surgery. Patients reported their quality of life using the EuroQol five dimensions questionnaire (EQ-5D), 36-item short form health survey (SF-36 and derived SF-6D) and a visual analogue scale (VAS). Using cost diaries patients reported health care use, non-health care use and hours of absenteeism from work. The 1-year societal costs were compared with 1-year quality adjusted life years (QALYs) based on the United States (US) EQ-5D. Sensitivity analyses were carried out on the use of different utility measures (Netherland (NL) EQ-5D, SF-6D, or VAS) and on the perspective (societal or healthcare).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>On the US EQ-5D, conventional surgery provided a non-significant gain in QALYs of 0.033 (95% confidence interval (CI) \u22120.026 to 0.093) in the first year. PLDD resulted in significantly lower healthcare costs (difference \u20ac1771, 95% CI \u20ac303 to \u20ac3238) and non-significantly lower societal costs (difference \u20ac2379, 95% CI \u2212\u20ac2860 to \u20ac7618). For low values of the willingness to pay for a QALY, the probability of being cost-effective is in favor of PLDD. For higher values of the willingness to pay, between \u20ac30,000 and \u20ac70,000, conventional microdiscectomy becomes favorable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>From a healthcare perspective PLDD, followed by surgery when needed, results in significantly lower 1-year costs than conventional surgery. From a societal perspective PLDD appears to be an economically neutral innovation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1591019917710297","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T13:39:43Z","timestamp":1499780383000},"page":"538-545","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Percutaneous laser disc decompression versus microdiscectomy for sciatica: Cost utility analysis alongside a randomized controlled trial"],"prefix":"10.1177","volume":"23","author":[{"given":"M Elske","family":"van den Akker-van Marle","sequence":"first","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick A","family":"Brouwer","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"},{"name":"Karolinska University Hospital, Solnav\u00e4gen, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Brand","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Koes","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbert B","family":"van den Hout","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A","family":"van Buchem","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilco C","family":"Peul","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,7,5]]},"reference":[{"key":"bibr1-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-10-49"},{"key":"bibr2-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2015.01.020"},{"key":"bibr3-1591019917710297","unstructured":"Gommans I and Koes BW. Validity and responsiveness of the Dutch adaptation of the Roland Disability Questionnaire. In: Tulder MW, Koes BW, Bouter LM (eds)\n                      Low Back Pain\n                      . Amsterdam, the Netherlands: EMGO, 1996, pp. 57\u201370."},{"key":"bibr4-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200503000-00003"},{"key":"bibr5-1591019917710297","first-page":"1574","volume":"149","author":"Lamers LM","year":"2005","journal-title":"Ned Tijdschr Geneeskd"},{"key":"bibr6-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000135827.18610.0d"},{"key":"bibr7-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462300009648"},{"key":"bibr8-1591019917710297","unstructured":"Statistics Netherlands. Consumer price index, www.cbs.nl (2008, accessed 3 April 2010)."},{"key":"bibr9-1591019917710297","unstructured":"Oostenbrink JB, Boumans CAM, Koopmanschap MA, et\u00a0al. Manual for cost analyses, methods and standard prices for economic evaluations in health care [In Dutch]. Amstelveen: Dutch Health Insurance Executive Board, 2004."},{"key":"bibr10-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19990330)18:6<681::AID-SIM71>3.0.CO;2-R"},{"key":"bibr11-1591019917710297","first-page":"1637","volume":"163","author":"Smulders YM","year":"2006","journal-title":"Ned Tijdschr Geneeskd"},{"key":"bibr12-1591019917710297","unstructured":"Council for Public Health and Health Care (RVZ). Sensible and sustainable care. Zoetermeer, the Netherlands: RVZ, 2006."},{"key":"bibr13-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39583.709074.BE"},{"key":"bibr14-1591019917710297","doi-asserted-by":"crossref","unstructured":"Brouwer PA, Brand R, van den Akker ME, et\u00a0al. Percutaneous laser disc decompression (PLDD) versus conventional microdiscectomy for patients with sciatica: Two-year results of a randomized controlled trial.\n                      Interv Neuroradiol\n                      (in press, accepted March 2017).","DOI":"10.1177\/1591019917699981"},{"key":"bibr15-1591019917710297","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.972"}],"container-title":["Interventional Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1591019917710297","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1591019917710297","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1591019917710297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:57:37Z","timestamp":1777460257000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1591019917710297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,5]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,10]]}},"alternative-id":["10.1177\/1591019917710297"],"URL":"https:\/\/doi.org\/10.1177\/1591019917710297","relation":{},"ISSN":["1591-0199","2385-2011"],"issn-type":[{"value":"1591-0199","type":"print"},{"value":"2385-2011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,5]]}}}