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Cervical disc arthroplasty is on the rise in United States, study finds

Issue: December 2011

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CHICAGO — Although anterior cervical discectomy and fusion is the most popular operative treatment for cervical disc disease, one study has found that the use of cervical disc arthroplasty is increasing in the United States.

The findings were presented by Steven M. Koehler, BA, here at the 2011 Annual Meeting of the North American Spine Society .

“We wanted to look at the trends and early adoption and usage … and try to provide a meta-level scrutiny of the clinical trials compared to national trends for [anterior cervical discectomy and fusion] ACDFs — and the FDA approval process in general,” Koehler said.

For their study, Koehler and colleagues used the Healthcare Cost and Utilization Project Nationwide Inpatient Sample database to identify 1,715 cervical disc arthroplasties and 321,154 ACDF procedures performed in the United States between 2004 and 2007.

The prevalence of each procedure, Koehler said, was calculated and stratified by age, gender, race, diagnosis, census region, primary payor class and hospital characteristics, along with length of stay and total charges.

Koehler noted a “significant increase” in cervical disc arthroplasty procedures, adding that large, urban non-teaching hospitals were most likely to perform the surgery. Gender, race, admission type and region all were found to be similar between the treatment cohorts, but patients with private or no insurance were significantly more likely to undergo cervical disc arthroplasty while those with Medicare and Medicaid were more likely to undergo ACDF.

Koehler reported that ACDF had an average total charge of $47,337, while cervical disc arthroplasty had an average charge of $33,905.

The study results also point to younger patients with fewer comorbidities undergoing cervical disc arthroplasty, Koehler said, adding that his team expects the procedure to continue to grow in popularity.

Reference:

• Qureshi S, Koehler S, Hecht A. National utilization trends of cervical artificial disc replacement compared to anterior cervical fusion. Paper #29. Presented at the 2011 Annual Meeting of the North American Spine Society. Nov. 2-5. Chicago.
• Disclosure: Koehler has no relevant financial disclosures.

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