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Is Single-Level Cervical Disc Arthroplasty Associated With A Lower Reoperation Rate Than Anterior Cervical Discectomy And Fusion? – Cervical Disc Replacement

The article presents a retrospective matched-cohort study comparing the rate of subsequent cervical spine surgery in patients who underwent single-level cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF). The study used records from a large national administrative claims database and identified 148,531 patients who met the criteria. After matching, the study included 28,795 ACDF patients and 14,504 CDA patients. The results showed that ACDF patients had higher rates of 90-day adverse events and readmissions. However, the rate of reoperation was similar between the two groups. CDA patients had a higher rate of subsequent injections and a lower rate of adverse events and readmissions. Overall, the study suggests that CDA is associated with similar reoperation rates and lower rates of adverse events compared to ACDF

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised treatment clinic in UK

Published article

CONCLUSIONS: Single-level CDA was associated with a similar rate of reoperation and higher rate of subsequent injections when compared with a matched cohort that underwent single-level ACDF. CDA was associated with lower rates of 90-day adverse events and readmissions.

Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Objective: Long-term meta-analysis of cervical disc arthroplasty (CDA) trials report lower rates of subsequent cervical spine surgical procedures with CDA compared with anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the rate of subsequent cervical spine surgery in single-level CDA-treated patients to that of a matched cohort of,

Abstract

Objective: Long-term meta-analysis of cervical disc arthroplasty (CDA) trials report lower rates of subsequent cervical spine surgical procedures with CDA compared with anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the rate of subsequent cervical spine surgery in single-level CDA-treated patients to that of a matched cohort of single-level ACDF-treated patients by using records from 2010 to 2021 included in a large national administrative claims database (PearlDiver).

Methods: This retrospective matched-cohort study used a large national insurance claims database; 525,510 patients who had undergone a single-level ACDF or CDA between 2010 and 2021 were identified. Patients with other same-day spine procedures, as well as those for trauma, infection, or tumor, were excluded, yielding 148,531 patients. ACDF patients were matched 2:1 to CDA patients on the basis of clinical and demographic characteristics. The primary outcome was the overall incidence of all-cause cervical reoperation after index surgery. Secondary outcomes included readmission, any adverse event within 90 days, and overall reintervention after index surgery. Multivariable logistic regression analyses were adjusted for covariates and were employed to estimate the effect of the index ACDF or CDA procedure on patient outcomes. Survival was assessed using Kaplan-Meier estimation, and differences between ACDF- and CDA-treated patients were compared using log-rank tests.

Results: After the patients were matched, 28,795 ACDF patients to 14,504 CDA patients were included. ACDF patients had higher rates of 90-day adverse events (18.4% vs 14.6%, adjusted odds ratio [aOR] 0.77, 95% CI 0.73-0.82, p < 0.001) and readmission (11.5% vs 9.7%, aOR 0.87, 95% CI 0.81-0.93, p < 0.001). Over a mean 4.3 years of follow-up, 5.0% of ACDF patients and 5.4% of CDA patients underwent reoperation (aOR 1.09, 95% CI 1.00-1.19, p = 0.059). The rate of aggregate reintervention was higher in CDA patients than in ACDF patients (11.7% vs 10.7%, aOR 1.10, p = 0.002). The Kaplan-Meier 10-year reoperation-free survival rate was worse for CDA than ACDF (91.0% vs 92.0%, p = 0.05), as was the rate of reintervention-free survival (81.2% vs 82.0%, p = 0.003) .

Conclusions: Single-level CDA was associated with a similar rate of reoperation and higher rate of subsequent injections when compared with a matched cohort that underwent single-level ACDF. CDA was associated with lower rates of 90-day adverse events and readmissions.

Keywords: arthroplasty; artificial disc replacement; cervical; degenerative disc disease; fusion; long-term follow-up; matched analysis; nationwide payer database; reoperation; subsequent surgery; total disc replacement.

The London Spine Unit : best recognised treatment clinic in UK

Read the original publication:

Is single-level cervical disc arthroplasty associated with a lower reoperation rate than anterior cervical discectomy and fusion?

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Abstract Objective: Long-term meta-analysis of cervical disc arthroplasty (CDA) trials report lower rates of subsequent cervical spine surgical procedures with CDA compared with anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the rate of subsequent cervical spine surgery in single-level CDA-treated patients to that of a matched cohort of

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