Treatment of cervical radiculopathy: A review of the evolution and economics

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...

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Detalles Bibliográficos
Autores principales: Ament, Jared D., Karnati, Tejas, Kulubya, Edwin, Kim, Kee D., Johnson, J. Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Spine: Original Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838835/
https://www.ncbi.nlm.nih.gov/pubmed/29527393
http://dx.doi.org/10.4103/sni.sni_441_17
Descripción
Sumario: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.

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