Cervical Disc Replacement: Trends, Costs, and Complications

Jain Nickul Saral; Nguyen Ailene; Formanek Blake; Alluri Ram; Buser Zorica; Hah Ray; Wang Jeffrey Chun

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저자정보: Jain Nickul Saral (University of Southern California Los Angeles CA USA) Nguyen Ailene (University of Southern California Los Angeles CA USA) Formanek Blake (University of Southern California Los Angeles CA USA) Alluri Ram (University of Southern California Los Angeles CA USA) Buser Zorica (University of Southern California Los Angeles CA USA) Hah Ray (University of Southern California Los Angeles CA USA) Wang Jeffrey Chun (University of Southern California Los Angeles CA USA)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.5

발행연도: 2020.1

수록면: 647 - 654 (8page)

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Study Design: Retrospective review of insurance database.Purpose: To investigate national trends, complications, and costs after cervical disc replacement (CDR) using an administrative insurance database representative of the United States population.Overview of Literature: As CDR continues to be used to treat patients with cervical stenosis, it is important to gain a better understanding of its use on a national level, potential complications, and cost. This information will allow for optimal patient counseling, risk stratification, and healthcare cost assessments. Several prior studies have investigated complications associated with CDR, but they have been limited by small sample size, single institution experiences, limited follow-up, and potential conflicts of interest.Methods: Patients who underwent single or multilevel CDR between 2007 and 2015 were identified using an insurance database. We collected data on annual trends, reimbursement costs, patient demographic information, hospital information, and information on complications from the time of operation to 1 year postoperative.Results: Total of 293 patients underwent either single or multilevel CDR. The number of procedures increased nonlinearly over time at an average of 17% per year, with a greater increase seen in the outpatient setting. Less than 3.7% of patients had new onset pain within 1 year after CDR. Within 1 year, 12.3% of patients reported a mechanical and/or bone-related complication. There were no patients who indicated a new nerve injury within 6 months of follow-up. Less than 3.7% of patients presented with dysphagia or dysphonia within 6 months, infection within 3 months, or a revision or reoperation within 1 year. Average reimbursement for single-level inpatient versus outpatient CDR was $33,696.28 and $34,675.12, respectively (p =0.29).Conclusions: This study demonstrated that the use of CDR continued to increase. The most common complication was mechanical and/or bone-related, and cost analysis demonstrated no significant difference between inpatient and outpatient CDR.

#Cervical disc arthroplasty #Complications #Costs and cost analysis #Demography

참고문헌 (30)

참고문헌 신청

Smith GW / 1958 / The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion / J Bone Joint Surg Am 40-A:607~624

Elsawaf A / 2009 / Effect of cervical dynamics on adjacent segment degeneration after anterior cervical fusion with cages / Neurosurg Rev 32:215~224

Hilibrand AS / 1999 / Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis / J Bone Joint Surg Am 81:519~528

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