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Is Total Disk Replacement a Cost-effective Treatment for Cervical Degenerative Disk Disease?
Bernd Wiedenhöfer1, Joachim Nacke, Mike Stephan
1*Department of Orthopaedics, Trauma Surgery and Spinal Cord Injury †Department of Anaesthesiology ‡Research Centre for Experimental Orthopaedics University Hospital of Heidelberg, Heidelberg §Stadtklinik Baden-Baden, Baden-Baden, Germany.
Clinical Spine Surgery
|May 20, 2017
Summary
Cervical total disk replacement (TDR) and spinal fusion (SF) yield similar clinical outcomes for degenerative disk disease. TDR is a more cost-effective option, offering comparable medical results with lower overall expenses.
Area of Science:
- Spine Surgery
- Health Economics
- Orthopedics
Background:
- Spine surgery has seen significant growth, increasing economic burden.
- Clinical outcomes between cervical total disk replacement (TDR) and spinal fusion (SF) appear similar.
- Economic data comparing TDR and SF procedures are lacking.
Purpose of the Study:
- To assess the cost-effectiveness of motion-preserving (TDR) versus fusion procedures (SF) in cervical spine surgery.
- To compare the economic factors associated with TDR and SF.
- To evaluate clinical outcomes alongside economic data for TDR versus SF.
Main Methods:
- Retrospective study of 467 monosegmental or bisegmental surgeries for degenerative disk pathologies.
- Utilized German statutory health insurance data from January 2003 to June 2008.
- Analyzed costs based on diagnosis-related groups and length of hospitalization.
Main Results:
- No significant difference in revision rates between TDR and SF groups.
- Cost weight of diagnosis-related groups and hospitalization length significantly impacted total costs.
- Both TDR and SF groups showed reduced pain medication use postoperatively; TDR patients had higher absenteeism but less rehabilitation costs.
Conclusions:
- Cervical TDR and SF demonstrate comparable medical outcomes for degenerative disk pathology.
- TDR is a cost-effective alternative to SF, with significantly lower associated costs.
- TDR presents a viable medical and financial choice for treating degenerative disk disease.