臨床整形外科54巻8号

2019年08月発行

誌上シンポジウム 整形外科治療の費用対効果

骨粗鬆症性椎体骨折に対するBalloon Kyphoplastyの費用対効果

著者： 高橋真治¹ 星野雅俊¹ 中村博亮¹

所属機関： ¹大阪市立大学医学部整形外科

ページ範囲：P.791 - P.797

　骨粗鬆症性椎体骨折に対する外科的治療の1つとしてballoon kyphoplasty(BKP)が広く行われているが，その費用対効果に関して各国で見解が異なっている．英国では費用対効果に優れるという結果であったが，スウェーデンでは許容範囲外であった．われわれが行った予後不良因子を有する椎体骨折患者へのBKPと保存治療に関する研究の結果，増分費用効果比が約242万円/QALYと許容範囲内であったが，80歳以上では費用対効果比が増加する傾向を認めた．しかし，80歳以上では他の侵襲的外科的治療が困難な保存治療抵抗例もあるため，低侵襲なBKPは治療選択肢の1つであると考える．

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