An article recently published in The Spine Journal compared revision one- and two-level cervical total disc replacement with anterior cervical discectomy and fusion.
Researchers used data from the Nationwide Inpatient Sample database from 2002 to 2011, including 3,536 ACDF revisions and 256 cervical TDR revisions. The researchers found greater costs and perioperative wound infection among the TDR revisions, but no difference in mortality.
The cost for TDR revision was $16,998 on average, compared with $15,222 for ACDF revision. Perioperative wound infections were 13.6 per 1,000 for TDR, compared to 5.3 per 1,000 for ACDF.
"We propose that these differences are by virtue of the inherently more invasive nature of revising total disc replacements," concluded the study authors.
Both ACDF and TDR revision procedures had greater length of stay, incidence and risk of perioperative wound infections, and higher cost than the primary procedures.
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