{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:43:31Z","timestamp":1777898611164,"version":"3.51.4"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Management of degenerative disease of the spine has evolved to favor minimally invasive techniques, including nonrobotic-assisted and robotic-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF). Value-based spending is being increasingly implemented to control rising costs in the US healthcare system. With an aging population, it is fundamental to understand which procedure(s) may be most cost-effective.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>OBJECTIVE:<\/jats:title>\n            <jats:p>To compare robotic and nonrobotic MIS-TLIF through a cost-utility analysis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We considered direct medical costs related to surgical intervention and to the hospital stay, as well as 1-yr utilities. We estimated costs by assessing all cases involving adults undergoing robotic surgery at a single institution and an equal number of patients undergoing nonrobotic surgery, matched by demographic and clinical characteristics. We adopted a willingness to pay of $50\u2009000\/quality-adjusted life year (QALY). Uncertainty was addressed by deterministic and probabilistic sensitivity analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>Costs were estimated based on a total of 76 patients, including 38 undergoing robot-assisted and 38 matched patients undergoing nonrobot MIS-TLIF. Using point estimates, robotic surgery was projected to cost $21\u2009546.80 and to be associated with 0.68 QALY, and nonrobotic surgery was projected to cost $22\u2009398.98 and to be associated with 0.67 QALY. Robotic surgery was found to be more cost-effective strategy, with cost-effectiveness being sensitive operating room\/materials and room costs. Probabilistic sensitivity analysis identified robotic surgery as cost-effective in 63% of simulations.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION:<\/jats:title>\n            <jats:p>Our results suggest that at a willingness to pay of $50\u2009000\/QALY, robotic-assisted MIS-TLIF was cost-effective in 63% of simulations. Cost-effectiveness depends on operating room and room (admission) costs, with potentially different results under distinct neurosurgical practices.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1227\/neu.0000000000001779","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T11:00:16Z","timestamp":1639393216000},"page":"192-198","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":42,"title":["Robotic-Assisted vs Nonrobotic-Assisted Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Cost-Utility Analysis"],"prefix":"10.1227","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3654-3387","authenticated-orcid":false,"given":"Diogo","family":"Garcia","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Oluwaseun O.","family":"Akinduro","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Gaetano","family":"De Biase","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal;"},{"name":"CINTESIS \u2013 Center for Health Technology and Services Research, University of Porto, Porto, Portugal;"}]},{"given":"Daniel J.","family":"Jerreld","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Ruchita","family":"Dholakia","sequence":"additional","affiliation":[{"name":"Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA;"},{"name":"Division of Health Care Delivery Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA;"}]},{"given":"Bijan","family":"Borah","sequence":"additional","affiliation":[{"name":"Robert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA;"},{"name":"Division of Health Care Delivery Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA;"}]},{"given":"Eric","family":"Nottmeier","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"H. Gordon","family":"Deen","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"W. Christopher","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}]},{"given":"Selby","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Alfredo","family":"Quinones-Hinojosa","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, USA;"}]},{"given":"Kingsley","family":"Abode-Iyamah","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida, 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SF-6D utility scores from the oswestry disability index and numeric rating scales for back and leg pain","volume":"34","author":"Carreon","year":"2009","journal-title":"Spine."},{"issue":"4","key":"R11-20250819","doi-asserted-by":"crossref","first-page":"e1917","DOI":"10.1002\/rcs.1917","article-title":"Comparative study of 1-year clinical and radiological outcomes using robot-assisted pedicle screw fixation and freehand technique in posterior lumbar interbody fusion: a prospective, randomized controlled trial","volume":"14","author":"Kim","year":"2018","journal-title":"Int J Med Robot."},{"issue":"17","key":"R12-20250819","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1097\/BRS.0b013e3181c70fe3","article-title":"Minimally invasive transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases","volume":"35","author":"Shunwu","year":"2010","journal-title":"Spine."},{"key":"R14-20250819","first-page":"9","article-title":"Robotic-assisted spine surgery: history, efficacy, cost, and future trends","volume":"6","author":"D\u2019Souza","year":"2019","journal-title":"Robot Surg."}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1227\/NEU.0000000000001779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T21:01:07Z","timestamp":1755637267000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1227\/NEU.0000000000001779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,13]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1227\/neu.0000000000001779","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,13]]},"assertion":[{"value":"2021-04-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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