A new study published in The Spine Journal examines cervical disc replacement and anterior cervical discectomy and fusion resource utilization across the U.S.
The study authors gathered data from the Nationwide Inpatient Sample for more than 1 million patients who underwent cervical spine surgery from 2006 to 2013. The data sample included 1.059 million ACDFs and 13,099 disc replacements covering both primary and revision procedures.
Study authors found:
1. The average number of spinal fusions increased 5.7 percent from 2006 to 2013, averaging around 132,425 procedures per year. In 2013, there were 127,500 ACDFs performed in the U.S.
2. Over the study period, cervical disc replacements increased 190 percent from 540 in 2006 to 1,565 in 2013. On average, there were 1,637 disc replacements performed per year. Fusions outpaced cervical disc replacements in the U.S. at a ratio of 81:1.
3. Cervical disc replacement patients trended younger than spinal fusion patients. Disc replacement was also associated with private insurance coverage and workers compensation.
4. The average length of stay for spinal fusions was 2.3 days, compared to 1.5 days for the disc replacement patients. Almost all of the patients reported routine discharge — 96 percent of the disc replacement group and 89 percent of the fusion group.
5. Spinal fusion patients had higher hospital-related costs, hitting $16,178, compared to disc replacement patients, who reported an average of $13,197 in hospital costs. However the revision rate was greater among the disc replacement patients, 5.9 percent, than among the fusion patients, 2.3 percent.