Which has lower societal costs for cervical spine surgery: Fusion or disc replacement? 5 things to know

Spine

The International Journal of Spine Surgery published an article examining the long-term societal costs of anterior discectomy and fusion compared to disc arthroplasty for cervical radiculopathy.

The study authors compiled an economic and decision analysis with the Markov model for long-term societal costs. The patients included in the study were 45 years old to 65 years old and underwent surgery for single-level cervical disc disease. The patients had failed nonoperative treatment.

 

The researchers found:

 

1. Long-term societal costs for the younger patients — 45 years old — undergoing anterior cervical discectomy and fusion was $31,178 on average. The costs for cervical disc arthroplasty for a 45-year-old patient were $24,119.

 

2. Long-term costs for cervical disc replacement were less expensive for patients throughout the 45 year old to 65 year old age range. Here is the breakdown for the cost differential between the fusion and disc arthroplasty:

 

• Age 50: $7,531
• Age 55: $7,236
• Age 60: $6,650
• Age 65: $6,008

 

3. Cervical disc replacement remained less expensive than fusion as long as the annual reoperation rates were below 10.5 percent, according to the study authors. The reported reoperation rate for cervical disc arthroplasty is 2.5 percent.

 

4. The direct costs for fusion include:

 

• Preoperative work-up: $1,188
• Anesthesia fee: $516
• Surgeon fee: $2,110
• Surgery and acute care: $9,735
• Rehab or home healthcare: $182
• Medications: $112
• Annual monitoring: $251

 

The direct costs for disc replacement wee:

 

• Preoperative work-up: $1,188
• Anesthesia fee: $516
• Surgeon fee: $1,675
• Surgery and acute care: $8,668
• Rehab or home healthcare: $36
• Medications: $112
• Annual monitoring: $251

 

5. The indirect cost for lost productivity was $6,066 for the fusion patients and $4,621 for the arthroplasty patients.

 

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