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Updated: Sep 2, 2025
Anterior Cervical Discectomy and Fusion in the Ovine Model
Published on: October 5, 2009
Cost analysis comparison between anterior and posterior cervical spine approaches
Alvin Y Chan1, Alexander S Himstead1, Elliot H Choi2
1Department of Neurological Surgery, University of California, Irvine, UCI Medical Center, Orange, California.
Background:
The costs of cervical spine surgery have steadily increased. We performed a 5-year propensity scoring-matched analysis of 276 patients undergoing anterior versus posterior cervical surgery at one institution.
Methods:
We performed propensity score matching on financial data from 276 patients undergoing 1-3 level anterior versus posterior cervical fusions for degenerative disease (2015-2019).
Results:
We found no significant difference between anterior versus posterior approaches for hospital costs ($42,529.63 vs. $45,110.52), net revenue ($40,877.25 vs. $34,036.01), or contribution margins ($14,230.19 vs. $6,312.54). Multivariate regression analysis showed variables significantly associated with the lower contribution margins included age (β = -392.3) and length of stay (LOS; β = -1151). Removing age/LOS from the analysis, contribution margins were significantly higher for the anterior versus posterior approach ($17,824.16 vs. $6,312.54, P = 0.01).
Conclusion:
Anterior cervical surgery produced higher contribution margins compared to posterior approaches, most likely because posterior surgery was typically performed in older patients requiring longer LOS.
