Cervical Disc Arthroplasty Usage Has Leveled Out From 2010 to 2021

Area of Science:

• Neurosurgery and Orthopedic Surgery
• Spine Surgery Outcomes
• Epidemiologic Studies

Background:

• Cervical disc arthroplasty (CDA) is an alternative to anterior cervical discectomy and fusion (ACDF) for cervical spine pathologies.
• Both procedures are used for similar indications, leading to ongoing debate on optimal treatment practices.

Purpose of the Study:

• To compare the utilization trends of single-level CDA versus ACDF.
• To identify predictive patient factors associated with choosing CDA over ACDF.
• To evaluate and compare the 5-year reoperation rates for both procedures.

Main Methods:

• A descriptive epidemiologic study analyzed data from 2010-2021.
• Identified patients undergoing single-level CDA or ACDF using the PearlDiver M151Ortho database.
• Assessed yearly utilization, determined predictive factors for CDA, and compared 5-year reoperation-free survival using Kaplan-Meier analysis.

Main Results:

• From 2010-2021, 19,301 CDAs and 181,476 ACDFs were performed.
• CDA utilization increased from 4.00% in 2010 to 14.15% in 2018, then plateaued at 14.47% by 2021.
• Younger age, commercial insurance, and surgery in the Midwest, Northeast, or West regions predicted CDA use. No significant difference in 5-year reoperation rates was observed (97.6% for CDA vs. 97.7% for ACDF).

Conclusions:

• CDA utilization rose significantly until 2018 but has since plateaued, representing a small fraction of single-level anterior cervical surgeries.
• Predictors for CDA include younger patient demographics, specific insurance types, and geographic location.
• Long-term outcomes show comparable 5-year reoperation rates between CDA and ACDF, suggesting similar efficacy in preventing further cervical spine surgery.