BACKGROUND: Thus study was a retrospective cohort analysis. Anterior cervical discectomy and fusion (ACDF) has been the gold-standard procedure for single-level degenerative disc disease (DDD). Recently, cervical disc arthroplasty (CDA) has become increasingly prevalent as an alternative intervention. OBJECTIVE: To examine the long-term costs and reoperation rates associated with CDA and ACDF for the treatment of single-level DDD. METHODS: In the present study, we performed a retrospective cohort analysis using the MarketScan database of patients who underwent either ACDF or CDA between 2007 and 2011 and had 5 years postsurgery follow-up. Outcomes related to the health care utilization, cost, and reoperation were analyzed after propensity score matching (PSM). RESULTS: Of 12,434 patients, 12,099 underwent ACDF and 335 CDA. Length of hospital stay and initial hospitalization cost was higher after ACDF compared with CDA. More patients undergoing CDA had early physical therapy compared with patients undergoing ACDF (CDA 30.15% vs. ACDF 22.39%; P = 0.0176). Five years after surgery, there was no significant difference in overall payments between patients undergoing ACDF and patients undergoing CDA. Reoperation rates were comparable at 5 years after the index procedure (CDA 8.06% vs. ACDF 9.25%; P = 0.5862). Patients who underwent ACDF showed decreased use of tramadol after surgery (15.09% before surgery vs. 9.55% after surgery; P < 0.0001). CONCLUSIONS: We found no difference in health care utilization between ACDF and CDA procedures for DDD 5 years after surgery. Also, there was no difference in reoperation rates during the study period. ACDF resulted in significant reduction in overall opioid use after versus before procedure.
BACKGROUND: Thus study was a retrospective cohort analysis. Anterior cervical discectomy and fusion (ACDF) has been the gold-standard procedure for single-level degenerative disc disease (DDD). Recently, cervical disc arthroplasty (CDA) has become increasingly prevalent as an alternative intervention. OBJECTIVE: To examine the long-term costs and reoperation rates associated with CDA and ACDF for the treatment of single-level DDD. METHODS: In the present study, we performed a retrospective cohort analysis using the MarketScan database of patients who underwent either ACDF or CDA between 2007 and 2011 and had 5 years postsurgery follow-up. Outcomes related to the health care utilization, cost, and reoperation were analyzed after propensity score matching (PSM). RESULTS: Of 12,434 patients, 12,099 underwent ACDF and 335 CDA. Length of hospital stay and initial hospitalization cost was higher after ACDF compared with CDA. More patients undergoing CDA had early physical therapy compared with patients undergoing ACDF (CDA 30.15% vs. ACDF 22.39%; P = 0.0176). Five years after surgery, there was no significant difference in overall payments between patients undergoing ACDF and patients undergoing CDA. Reoperation rates were comparable at 5 years after the index procedure (CDA 8.06% vs. ACDF 9.25%; P = 0.5862). Patients who underwent ACDF showed decreased use of tramadol after surgery (15.09% before surgery vs. 9.55% after surgery; P < 0.0001). CONCLUSIONS: We found no difference in health care utilization between ACDF and CDA procedures for DDD 5 years after surgery. Also, there was no difference in reoperation rates during the study period. ACDF resulted in significant reduction in overall opioid use after versus before procedure.
Authors: Austen David Katz; Junho Song; Daniel Bowles; Terence Ng; Eric Neufeld; Sayyida Hasan; Dean Perfetti; Nipun Sodhi; David Essig; Jeff Silber; Sohrab Virk Journal: J Craniovertebr Junction Spine Date: 2022-09-14
Authors: Venkat Boddapati; Nathan J Lee; Justin Mathew; Meghana M Vulapalli; Joseph M Lombardi; Marc D Dyrszka; Zeeshan M Sardar; Ronald A Lehman; K Daniel Riew Journal: Global Spine J Date: 2020-07-24
Authors: Nathan J Lee; Andrei F Joaquim; Venkat Boddapati; Justin Mathew; Paul Park; Jun S Kim; Zeeshan M Sardar; Ronald A Lehman; K Daniel Riew Journal: Global Spine J Date: 2021-01-19