Comparing the 5-Year Health State Utility Value of Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion. Issue 1 (February 2018)

• Record Type: Journal Article
• Authors: McAnany, Steven J.; Merrill, Robert K.; Brochin, Robert L.; Overley, Samuel C.; Kim, Jun S.; Qureshi, Sheeraz A.
• Is Part Of: Global spine journal. Volume 8:Issue 1(2018)
• Page Start: 6
• Page End: 10
• Publication Date: 2018-02
• Subjects: health state utility -- cervical disc replacement -- anterior cervical discectomy and fusion -- cervical surgery -- spine surgery -- cost-effectiveness analysis; Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1177/2192568217721893
• Languages: English
• ISSNs: 2192-5682

Abstract

Study Design: Health utility analysis. Objectives: To determine the health state utility (HSU) of 1- and 2-level anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR). Methods: Data from the Medtronic Prestige Cervical Disc investigational device exemption studies was used. Four groups were defined: 1-level ACDF, 1-level CDR, 2-level ACDF, and 2-level CDR. The 36-item Short Form Health Survey (SF-36) was collected at baseline, 12 months, 24 months, 36 months, and 60 months postoperatively and converted into utility scores for each time point. A repeated-measures 1-way analysis of variance (ANOVA) was used to detect differences among groups. Tukey's method for multiple comparisons was used to determine which means within the groups were statistically different ( P < .05). Results: We found a statistically significant difference in HSU among groups as determined by repeated-measures 1-way ANOVA ( P = .0008). Post hoc analysis indicated that 1-level ACDF had a statistically lower utility score compared with 1- and 2-level CDR ( P = .04 and P = .02, respectively). Similarly, 2-level ACDF had lower utility values compared with 2-level CDR ( P = .010). One-level ACDF utility values were not different from 2-level ACDF values ( P = .55). Similarly, 1-level CDR and 2-level CDR did not have different utility values ( P = .67). Conclusions: Overall, CDR had higher health state utility scores for 1- and 2-level procedures at every time point. This study indicates that CDR results in a higher postoperative health utility state than ACDF, and may therefore be an effective alternative to ACDF for treating degenerative conditions of the cervical spine.