AN ECONOMIC COST MODEL FOR PATIENT-SPECIFIC INTERVERTEBRAL DISC IMPLANTS

Back pain is a common concern amongst a growing population across the world today. Depending on the severity of a patient’s condition, and after conservative treatment options have been exhausted, total disc replacement (TDR) surgery may be prescribed as a corrective treatment. Several existing artificial disc implants are available on the market and are manufactured in standard sizes by means of conventional manufacturing processes – which typically involves machining operations. During surgery, surgeons try to select the most suitable implant size to match the patient’s anatomy by pushing various trial sizes into the vertebral space before placing the final implant. This trial-and-error technique relies heavily on the level of experience of the surgeon and could lead to TDR device under sizing and inaccurate positioning of the implant, which could lead to implant subsidence and bone fracture. As various imaging, software and manufacturing technologies have developed, the option for patient-specific implants by means of Rapid Manufacturing is becoming a realistic alternative. Patient-specific implants offer several potential clinical benefits to the patient, but it is important to investigate its cost implications. This paper discusses a cost model for patient-specific disc implants, and the potential advantages as well as challenges of using customized implants within the South African context.