Cervical discectomy without fusion cost-effective strategy

(HealthDay)—Anterior cervical discectomy without fusion (ACD) may be the most effective and cost-effective alternative for the treatment of one-level cervical disc disease, according to research published in the Dec. 1 issue of Spine.

Daniel J. Lewis, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, and colleagues conducted a literature search to identify articles comparing anterior cervical discectomy with fusion (with autograft, allograft, or spacers), ACD, and cervical disc replacement (CDR) for the treatment of one-level cervical disc disease. Pooled analysis was conducted to assess the incidence of various outcomes, including index-level and adjacent-level reoperation. Expected costs and outcomes in quality-adjusted life years for a typical adult patient with one-level cervical radiculopathy were also assessed.

The researchers found that, five years postoperatively, patients who had undergone ACD alone had significantly (P < 0.001) more quality-adjusted life years (4.885) compared to those receiving other treatments. The lowest societal costs ($16,558) were also seen with patients receiving ACD (P < 0.001).

"ACD is a cost-effective alternative to anterior cervical discectomy with fusion and CDR in patients with single-level cervical disc disease," the authors write.

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