TY - JOUR
T1 - Treatment of cervical radiculopathy
T2 - A review of the evolution and economics
AU - Ament, Jared
AU - Karnati, Tejas
AU - Kulubya, Edwin
AU - Kim, Kee D
AU - Johnson, J.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: The surgical treatment of cervical radiculopathy has centered around anterior cervical discectomy and fusion (ACDF). Alternatively, the posterior cervical laminoforaminotomy/microdiscectomy (PCF/PCM), which results in comparable outcomes and is more cost-effective, has been underutilized. Methods: Here, we compared the direct/indirect costs, reoperation rates, and outcome for ACDF and PCF vs. PCM using PubMed, Medline, and Embase databases. Results: There were no significant differences between the re-operative rates of PCF/PCM (2% to 9.8%) versus ACDF (2% to 8%). Direct costs of ACDF were also significantly higher; the 1-year cost-utility analysis demonstrated that ACDF had $131,951/QALY while PCM had $79,856/QALY. Conclusion: PCF/PCM for radiculopathy are safe and more cost-effective vs. ACDF, and have similar clinical outcomes.
AB - Background: The surgical treatment of cervical radiculopathy has centered around anterior cervical discectomy and fusion (ACDF). Alternatively, the posterior cervical laminoforaminotomy/microdiscectomy (PCF/PCM), which results in comparable outcomes and is more cost-effective, has been underutilized. Methods: Here, we compared the direct/indirect costs, reoperation rates, and outcome for ACDF and PCF vs. PCM using PubMed, Medline, and Embase databases. Results: There were no significant differences between the re-operative rates of PCF/PCM (2% to 9.8%) versus ACDF (2% to 8%). Direct costs of ACDF were also significantly higher; the 1-year cost-utility analysis demonstrated that ACDF had $131,951/QALY while PCM had $79,856/QALY. Conclusion: PCF/PCM for radiculopathy are safe and more cost-effective vs. ACDF, and have similar clinical outcomes.
KW - Cervical degenerative disc disease
KW - cervical disc herniation
KW - cost-effectiveness
KW - posterior approach
KW - posterior cervical microdiscectomy
KW - quality of life
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U2 - 10.4103/sni.sni_441_17
DO - 10.4103/sni.sni_441_17
M3 - Article
AN - SCOPUS:85043503028
VL - 9
JO - Surgical Neurology International
JF - Surgical Neurology International
SN - 2152-7806
IS - 1
M1 - 35
ER -