TY - JOUR
T1 - Comparing the 5-Year Health State Utility Value of Cervical Disc Replacement and Anterior Cervical Discectomy and Fusion
AU - McAnany, Steven J.
AU - Merrill, Robert K.
AU - Brochin, Robert L.
AU - Overley, Samuel C.
AU - Kim, Jun S.
AU - Qureshi, Sheeraz A.
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - 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.
AB - 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.
KW - anterior cervical discectomy and fusion
KW - cervical disc replacement
KW - cervical surgery
KW - cost-effectiveness analysis
KW - health state utility
KW - spine surgery
UR - http://www.scopus.com/inward/record.url?scp=85041839445&partnerID=8YFLogxK
U2 - 10.1177/2192568217721893
DO - 10.1177/2192568217721893
M3 - Article
AN - SCOPUS:85041839445
SN - 2192-5682
VL - 8
SP - 6
EP - 10
JO - Global Spine Journal
JF - Global Spine Journal
IS - 1
ER -