The article presents the findings of a descriptive epidemiologic study comparing the trends and factors associated with the utilization of single-level cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) over the years. The study analyzed data from the 2010-2021 PearlDiver M151Ortho dataset and identified 19,301 CDAs and 181,476 ACDFs. The proportional utilization of CDA relative to ACDF increased from 2010 to 2018, reaching 14.15%, but plateaued at 14.47% between 2018 and 2021. Several factors were found to predict the use of CDA over ACDF, including younger age, region of surgery, type of insurance, and surgical specialty. There was no significant difference in the 5-year survival rate between the two procedures. The reasons for the observed changes in trends remain unclear
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : the highest rated day surgery hospital in UK
Published article
While the use of CDA relative to ACDF rose from 2010 to 2018, its use has subsequently plateaued between 2018 and 2021 and remained a relatively low percent of the single level anterior cervical surgeries performed (14.47% in 2021). Causes for such changes in trend are unclear.
Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Study design: Descriptive epidemiologic study. Objective: To compare trends in utilization and predictive factors for single-level cervical disc arthroplasty (CDA) relative to anterior cervical discectomy and fusion (ACDF) over the years. Background: CDA is an alternative to ACDF for the treatment of cervical spine pathologies. With both procedures performed for similar indications, controversy on,
Abstract
Study design: Descriptive epidemiologic study.
Objective: To compare trends in utilization and predictive factors for single-level cervical disc arthroplasty (CDA) relative to anterior cervical discectomy and fusion (ACDF) over the years.
Background: CDA is an alternative to ACDF for the treatment of cervical spine pathologies. With both procedures performed for similar indications, controversy on best practice exists.
Methods: Patients who underwent single-level CDA or ACDF were identified in the 2010 through 2021 PearlDiver M151Ortho dataset. The yearly number of CDAs performed and proportionality were assessed. Predictive patient factors for undergoing CDA as opposed to ACDF were determined. Kaplan Meyer survival analysis with an endpoint of cervical spine reoperation compared 5-year outcomes between CDA and ACDF.
Results: From 2010-2021, 19,301 single-level CDAs and 181,476 single-level ACDFs were identified. The proportional utilization of CDA relative to ACDF increased from 4.00% in 2010 to 14.15% in 2018 (P<0.0001), after which there was a plateau between 2018 and 2021 where proportional utilization was 14.47% (P=0.4654). Multivariate analysis identified several predictors of undergoing CDA rather than ACDF, including: younger age (odds ratio [OR] per decade decrease 1.72), having surgery performed in the Midwest, Northeast, or West (relative to South, OR 1.16, 1.13, 2.26, respectively), having Commercial insurance (relative to Medicare, OR 1.75), and having surgery performed by an orthopedic surgeon (relative to neurological surgeon, OR 1.54) (P<0.0001 for each). There was no statistically significant difference in 5-year survival to further cervical spine surgery between CDA and ACDF at five years (97.6% vs. 97.7%, P=0.4249).
While the use of CDA relative to ACDF rose from 2010 to 2018, its use has subsequently plateaued between 2018 and 2021 and remained a relatively low percent of the single level anterior cervical surgeries performed (14.47% in 2021). Causes for such changes in trend are unclear.
The London Spine Unit : the highest rated day surgery hospital in UK
Read the original publication:
Cervical Disc Arthroplasty Usage has Leveled out from 2010 to 2021
