Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient
Objective The aim of this study was to compare all-cause reoperation rates and costs in nonelderly patients treated with anterior cervical discectomy and fusion (ACDF) with structural allograft versus synthetic cages for degenerative pathology. Methods We queried a private claims database to identif...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2020-12-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2040216-108.pdf |
| _version_ | 1797333425325080576 |
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| author | Majd Marrache Rachel Bronheim Andrew B. Harris Varun Puvanesarajah Micheal Raad Sang Lee Richard Skolasky Amit Jain |
| author_facet | Majd Marrache Rachel Bronheim Andrew B. Harris Varun Puvanesarajah Micheal Raad Sang Lee Richard Skolasky Amit Jain |
| author_sort | Majd Marrache |
| collection | DOAJ |
| description | Objective The aim of this study was to compare all-cause reoperation rates and costs in nonelderly patients treated with anterior cervical discectomy and fusion (ACDF) with structural allograft versus synthetic cages for degenerative pathology. Methods We queried a private claims database to identify adult patients (≤ 65 years) who underwent single-level ACDF in a hospital setting using either structural allograft or a synthetic cage (polyetheretherketone, metal, or hybrid device), from 2010 to 2016. The rate of all-cause reoperations at 2 years were compared between the 2 groups. Index hospitalization costs and 90-day complication rates were also compared. Significance was set at p < 0.05. Results A total of 26,754 patients were included in the study. 11,514 patients (43%) underwent ACDF with structural allograft and 15,240 (57%) underwent ACDF with a synthetic cage. The patients in the allograft group were younger and more likely to be male. There was no significant difference between the 2 groups with respect to 90-day complications including: wound dehiscence, dysphagia, dysphonia, and hematoma/seroma. In the 2-year postoperative period, the synthetic cage group had a significantly higher rate of allcause reoperation compared to the allograft group (9.1% vs. 8.0%, p = 0.002). Index hospitalization costs were significantly higher in the synthetic cage group compared to those in the allograft group ($23,475 vs. $20,836, p < 0.001). Conclusion Structural allograft is associated with lower all-cause reoperation rates and lower index costs in nonelderly patients undergoing ACDF surgery for degenerative pathology. It is important to understand this data as we transition toward value-based care. |
| first_indexed | 2024-03-08T08:03:37Z |
| format | Article |
| id | doaj.art-79beb1d078114f23b18a2e02d1d5514e |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T08:03:37Z |
| publishDate | 2020-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-79beb1d078114f23b18a2e02d1d5514e2024-02-02T11:41:05ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912020-12-0117489690110.14245/ns.2040216.1081093Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly PatientMajd Marrache0Rachel Bronheim1Andrew B. Harris2Varun Puvanesarajah3Micheal Raad4Sang Lee5Richard Skolasky6Amit Jain7 Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USAObjective The aim of this study was to compare all-cause reoperation rates and costs in nonelderly patients treated with anterior cervical discectomy and fusion (ACDF) with structural allograft versus synthetic cages for degenerative pathology. Methods We queried a private claims database to identify adult patients (≤ 65 years) who underwent single-level ACDF in a hospital setting using either structural allograft or a synthetic cage (polyetheretherketone, metal, or hybrid device), from 2010 to 2016. The rate of all-cause reoperations at 2 years were compared between the 2 groups. Index hospitalization costs and 90-day complication rates were also compared. Significance was set at p < 0.05. Results A total of 26,754 patients were included in the study. 11,514 patients (43%) underwent ACDF with structural allograft and 15,240 (57%) underwent ACDF with a synthetic cage. The patients in the allograft group were younger and more likely to be male. There was no significant difference between the 2 groups with respect to 90-day complications including: wound dehiscence, dysphagia, dysphonia, and hematoma/seroma. In the 2-year postoperative period, the synthetic cage group had a significantly higher rate of allcause reoperation compared to the allograft group (9.1% vs. 8.0%, p = 0.002). Index hospitalization costs were significantly higher in the synthetic cage group compared to those in the allograft group ($23,475 vs. $20,836, p < 0.001). Conclusion Structural allograft is associated with lower all-cause reoperation rates and lower index costs in nonelderly patients undergoing ACDF surgery for degenerative pathology. It is important to understand this data as we transition toward value-based care.http://www.e-neurospine.org/upload/pdf/ns-2040216-108.pdfanterior cervical discectomy and fusionradiculopathyreoperationhospital costsallograftssynthetic cage |
| spellingShingle | Majd Marrache Rachel Bronheim Andrew B. Harris Varun Puvanesarajah Micheal Raad Sang Lee Richard Skolasky Amit Jain Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient Neurospine anterior cervical discectomy and fusion radiculopathy reoperation hospital costs allografts synthetic cage |
| title | Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient |
| title_full | Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient |
| title_fullStr | Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient |
| title_full_unstemmed | Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient |
| title_short | Synthetic Cages Associated With Increased Rates of Revision Surgery and Higher Costs Compared to Allograft in ACDF in the Nonelderly Patient |
| title_sort | synthetic cages associated with increased rates of revision surgery and higher costs compared to allograft in acdf in the nonelderly patient |
| topic | anterior cervical discectomy and fusion radiculopathy reoperation hospital costs allografts synthetic cage |
| url | http://www.e-neurospine.org/upload/pdf/ns-2040216-108.pdf |
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