{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T12:15:58Z","timestamp":1771071358696,"version":"3.50.1"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:sec><jats:title>Object<\/jats:title><jats:p>Standard treatment options for patients with lumbar spinal stenosis include nonoperative therapies as well as decompressive laminectomy. The introduction of interspinous decompression devices such as the X-STOP has broadened treatment options, but data comparing these treatment strategies are lacking. The object of this study was to provide a cost-effectiveness analysis of laminectomy, interspinous decompression, and nonoperative treatment for patients with lumbar stenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The authors performed a structured literature review of lumbar stenosis and constructed a cost-effectiveness model. Using conservative treatment, decompressive laminectomy, and placement of X-STOP as the treatment arms, their primary analysis evaluated the optimal treatment strategy for a patient with lumbar stenosis at a 2-year time horizon. Secondary analyses were done to compare cases in which patients required single-level procedures with those in which multilevel procedures were required as well as to examine the outcomes for a 4-year time horizon. Outcomes were calculated using quality-adjusted life years and costs were considered from the perspective of society.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Laminectomy was found to be the most effective treatment strategy, followed by X-STOP and then conservative treatment at a 2-year time horizon. Both surgical procedures were more costly than conservative treatment. Because laminectomy was both more effective and less costly than X-STOP, it is said to dominate overall. When single level procedures were considered alone, laminectomy was more effective but also more costly than X-STOP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lumbar laminectomy appears to be the most cost-effective treatment strategy for patients with symptomatic lumbar spinal stenosis.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.3.spine09552","type":"journal-article","created":{"date-parts":[[2010,7,1]],"date-time":"2010-07-01T14:17:42Z","timestamp":1277993862000},"page":"39-46","source":"Crossref","is-referenced-by-count":57,"title":["Cost-effectiveness of current treatment strategies for lumbar spinal stenosis: nonsurgical care, laminectomy, and X-STOP"],"prefix":"10.3171","volume":"13","author":[{"given":"Mark G.","family":"Burnett","sequence":"first","affiliation":[{"name":"1Department of Neurosurgery, NeuroTexas Institute, Austin, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherman C.","family":"Stein","sequence":"additional","affiliation":[{"name":"2Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronald H. 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