The Seven-Year Cost-Effectiveness of Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty

Kim, Jun; Dowdell, James; Cheung, Zoe B.; Arvind, Varun; Sun, Li; Jandhyala, Chanakya; Ukogu, Chierika; Ranson, William A.; Jacobs, Samantha; McAnany, Steven J.

doi:10.1097/brs.0000000000002665

Cited by 33 publications

(19 citation statements)

References 39 publications

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“…[ 4 – 8 ] In addition, studies showed that both 1-level and 2-level CDR is more cost-effective in long-term follow-up. [ 9 , 10 ] Therefore, CDR has been widely used in recent years. [ 11 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement

et al. 2020

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Background: Cervical disc replacement (CDR) has been widely used as an effective treatment for cervical degenerative disc diseases in recent years. However, the cost of this procedure is very high and may bring a great economic burden to patients and the health care system. It is reported that outpatient procedures can reduce nearly 30% of the costs associated with hospitalization compared with inpatient procedures. However, the safety profile surrounding outpatient CDR remains poorly resolved. This study aims to evaluate the current evidence on the safety of outpatient CDR Methods: Four English databases were searched. The inclusion and exclusion criteria were developed according to the PICOS principle. The titles and abstracts of the records will be screened by 2 authors independently. Records that meet the eligibility criteria will be screened for a second time by reading the full text. An extraction form will be established for data extraction. Risk of bias assessment will be performed by 2 authors independently using Cochrane risk of bias tool or Newcastle–Ottawa scale. Data synthesis will be conducted using Stata software. Heterogeneity among studies will be assessed using I 2 test. The funnel plot, Egger regression test, and Begg rank correlation test will be used to examine the publication bias. Results: The results of this meta-analysis will be published in a peer-review journal. Conclusion: This will be the first meta-analysis that compares the safety of outpatient CDR with inpatient CDR. Our study will help surgeons fully understand the complications and safety profile surrounding outpatient CDR. OSF registration number: doi.org/10.17605/OSF.IO/3597Z

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Section: Introductionmentioning

confidence: 99%

Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement

et al. 2020

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“…86,89 Moreover, several studies have demonstrated that CDA may be more cost-effective with 5-to 7-year follow-up. [80][81][82][83][84][85]87 Yet, ACDF surgery continues to be the more commonly used procedure. [71][72][73] Future studies are needed to demonstrate long-term follow-up on prosthesis survival and clinical outcomes to further elucidate the cost-effectiveness of cervical disc arthroplasty compared to ACDF, and determine if more widespread adoption is warranted.…”

Section: Resultsmentioning

confidence: 99%

“…reported that the 7 year cost for CDA and ACDF was $105,332 and $103,911, respectively. 85 The authors also illustrated that the QALYs gained for ACDF and CDA was 5. 16 85 Overall results of these studies suggest that at 7-year follow-up, CDA continued to be a more cost-effective treatment strategy compared to ACDF.…”

Section: Comparison Of Cost-effectiveness Between Acdf and Cdamentioning

confidence: 97%

“…Since the FDA approved cervical disc replacements in 2007, various studies have investigated the cost-effectiveness of these devices compared to ACDF. 47,78,[80][81][82][83][84][85][86][87] In a CEA study comparing single-level CDA and ACDF utilizing Medicare charge and reimbursement data, Qureshi et al reported that, assuming 20-year prosthesis survival, CDA was the more costeffective surgical intervention over the lifetime of a patient with a CER of $3,042 compared to $8,760 per QALY for CDA and ACDF, respectively. 80 In addition, the authors reported that CDA was the more cost-effective intervention with an ICER of $2,394 per QALY.…”

Section: Comparison Of Cost-effectiveness Between Acdf and Cdamentioning

confidence: 99%

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Financial Aspects of Cervical Disc Arthroplasty: A Narrative Review of Recent Literature

et al. 2020

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Whether the process of adjacent disc degeneration is altered by CDA has not been addressed. [ 25 – 29 ] At the final FU, 3 of 105 patients had radiographic adjacent segment degeneration without symptoms, and the incidence rate was 2.8%, which may be associated with a high incidence of postoperative prosthesis-related complications. However, it can be seen from Figure 4 that in the case where the segmental activity was well preserved, the superior disc still degenerated.…”

Section: Discussionmentioning

confidence: 99%

Implant complications after one-level or two-level cervical disc arthroplasty

Liang¹,

Zhong

Tang

et al. 2020

Medicine

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The aim of study was to investigate the complications of cervical disc arthroplasty (CDA) and to discuss the factors affecting the mobility of the prosthesis and the measures to prevent these complications. Hundred and five patients who underwent CDA between 2009 and 2016 were enrolled. The clinical and radiographic outcomes were used to assess and the complications were recorded as well. All the patients were followed-up with an average of 41.30 ± 16.90 months with an average age of 47.90 ± 9.22 years. The visual analogue scale (VAS), neck disability index (NDI), and Japanese Orthopaedic Association (JOA) scores improved significantly at the final follow-up (FU) compared with the preoperative values. At the final FU, the overall incidence of heterotopic ossification (HO) was 51.42%. The distribution of different grades of HO was low-level HO (53.7%) and high-level HO (46.3%). No significant differences were found in the NDI, VAS, or JOA scores between patients with HO and those without HO ( P > .05). In the high-level HO patients, the range of mobility (ROM) was significantly reduced compared with the low-level HO patients and those without HO ( P < .05). The anterior displacement, subsidence, and instability were observed in 1 patient respectively and the segmental kyphosis, adjacent segment degeneration in 3 patients respectively. The patient of CDA instability also suffered severe neck pain and the revision surgery was performed. Postoperative complications in CDA such as HO, segmental kyphosis, and prosthesis displacement are prone to occur, affecting prosthesis mobility. Surgical indications should be strictly controlled, and intraoperative and postoperative treatments should be given great attention in order to reduce prosthesis-related complications.

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The Seven-Year Cost-Effectiveness of Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty

Abstract: 1.

Cited by 33 publications

References 39 publications

Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement

Comparison of the safety of outpatient cervical disc replacement with inpatient cervical disc replacement

Financial Aspects of Cervical Disc Arthroplasty: A Narrative Review of Recent Literature

Implant complications after one-level or two-level cervical disc arthroplasty

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