Comparing the 5-Year Health State Utility Value of Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion

Steven J. McAnany, Robert K. Merrill, Robert L. Brochin, Samuel C. Overley, Jun S. Kim, Sheeraz A. Qureshi

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


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.

Original languageEnglish
Pages (from-to)6-10
Number of pages5
JournalGlobal Spine Journal
Issue number1
StatePublished - 1 Feb 2018


  • anterior cervical discectomy and fusion
  • cervical disc replacement
  • cervical surgery
  • cost-effectiveness analysis
  • health state utility
  • spine surgery


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