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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.

Author information

1
Department of Neurological Surgery, University of California, Sacramento, California, USA.
2
The Spine Surgery Institute, Cedars Sinai Medical Center, Los Angeles, California, USA.

Abstract

Background:

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.

Methods:

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

Results:

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.

Conclusion:

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

KEYWORDS:

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

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