• World Neurosurg · Dec 2022

    Primary and Revision Cervical Disc Arthroplasty from 2010-2020: Patient Demographics, Utilization Trends, and Health Care Reimbursements.

    • Adam M Gordon, Ivan J Golub, Mitchell K Ng, Aaron W Lam, John K Houten, and Ahmed Saleh.
    • Department of Orthopedic Surgery, Maimonides Medical Center, Brooklyn, New York, USA. Electronic address: MMCOrthoresearch1@Gmail.com.
    • World Neurosurg. 2022 Dec 1; 168: e344e349e344-e349.

    ObjectivesDespite lack of nationwide Medicare coverage by the Centers for Medicare and Medicaid Services, the utilization of cervical disc arthroplasty (CDA) has risen in popularity. The purpose was to compare primary and revision CDA from 2010 to 2020 with respect to: (1) utilization trends, (2) patient demographics, and (3) health care reimbursements.MethodsUsing the PearlDiver database, we studied patients undergoing primary and revision CDA for degenerative cervical spine pathology from 2010 to 2020. Endpoints of the study were to compare patient demographics (including Elixhauser Comorbidity Index [ECI]), annual utilization trends, length of stay (LOS), and reimbursements. Chi-square analyses compared patient demographics. t tests compared LOS and reimbursements. A linear regression was used to evaluate for trends in procedural volume over time. P values <0.05 were considered statistically significant.ResultsIn total, 15,306 patients underwent primary (n = 14,711) or revision CDA (n = 595). Patients undergoing revisions had a greater comorbidity burden (mean ECI 4.16 vs. 2.91; P < 0.0001). From 2010 to 2020, primary CDA utilization increased by 413% (447 vs. 2297 procedures; P < 0.001); comparatively, revision CDA utilization increased by 141% (32 vs. 77 procedures; P < 0.001). Mean LOS was greater for revision cases (1.37 vs. 3.30 days, P < 0.001). Reimbursements for revisions were higher on the day of surgery ($5585 vs. $13,692) and within 90 days of surgery ($7031 vs. $19,340), all P < 0.0001.ConclusionsThere is a high rate of annual growth in CDA utilization and revision CDA in the United States. Reimbursements for revision CDA were more than double primary cases.Copyright © 2022 Elsevier Inc. All rights reserved.

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