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Surg Neurol Int. 2018 Feb 14;9:35. doi: 10.4103/sni.sni_441_17. eCollection 2018.

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

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Department of Neurological Surgery, University of California, Sacramento, California, USA.
The Spine Surgery Institute, Cedars Sinai Medical Center, Los Angeles, California, USA.



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.


Here, we compared the direct/indirect costs, reoperation rates, and outcome for ACDF and PCF vs. PCM using PubMed, Medline, and Embase databases.


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.


PCF/PCM for radiculopathy are safe and more cost-effective vs. ACDF, and have similar clinical outcomes.


Cervical degenerative disc disease; cervical disc herniation; cost-effectiveness; posterior approach; posterior cervical microdiscectomy; quality of life

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