{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:23:17Z","timestamp":1782127397557,"version":"3.54.5"},"reference-count":25,"publisher":"Asian Spine Journal (ASJ)","issue":"4","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2023,8,31]]},"abstract":"<jats:p>Study Design: Retrospective cohort study.Purpose: To characterize the postoperative outcomes and economic costs of anterior cervical discectomy and fusion (ACDF) procedures using synthetic biomechanical intervertebral cage (BC) and structural allograft (SA) implants.Overview of Literature: ACDF is a common spine procedure that typically uses an SA or BC for the cervical fusion. Previous studies that compared the outcomes between the two implants were limited by small sample sizes, short-term postoperative outcomes, and procedures with single-level fusion.Methods: Adult patients who underwent an ACDF procedure in 2007\u20132016 were included. Patient records were extracted from MarketScan, a national registry that captures person-specific clinical utilization, expenditures, and enrollments across millions of inpatient, outpatient, and prescription drug services. Propensity-score matching (PSM) was employed to match the patient cohorts across demographic characteristics, comorbidities, and treatments.Results: Of 110,911 patients, 65,151 (58.7%) received BC implants while 45,760 (41.3%) received SA implants. Patients who underwent BC surgeries had slightly higher reoperation rates within 1 year after the index ACDF procedure (3.3% vs. 3.0%, &lt;i&gt;p&lt;\/i&gt;=0.004), higher postoperative complication rates (4.9% vs. 4.6%, &lt;i&gt;p&lt;\/i&gt;=0.022), and higher 90-day readmission rates (4.9% vs. 4.4%, &lt;i&gt;p&lt;\/i&gt; =0.001). After PSM, the postoperative complication rates did not vary between the two cohorts (4.8% vs. 4.6%, &lt;i&gt;p&lt;\/i&gt;=0.369), although dysphagia (2.2% vs. 1.8%, &lt;i&gt;p&lt;\/i&gt;&lt;0.001) and infection (0.3% vs. 0.2%, &lt;i&gt;p&lt;\/i&gt;=0.007) rates remained higher for the BC group. Other outcome differences, including readmission and reoperation, decreased. Physician\u2019s fees remained high for BC implantation procedures.Conclusions: We found marginal differences in clinical outcomes between BC and SA ACDF interventions in the largest published database cohort of adult ACDF surgeries. After adjusting for group-level differences in comorbidity burden and demographic characteristics, BC and SA ACDF surgeries showed similar clinical outcomes. Physician\u2019s fees, however, were higher for BC implantation procedures.<\/jats:p>","DOI":"10.31616\/asj.2022.0261","type":"journal-article","created":{"date-parts":[[2023,5,26]],"date-time":"2023-05-26T01:31:38Z","timestamp":1685064698000},"page":"620-631","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical Outcomes and Cost Profiles for Cage and Allograft Anterior Cervical Discectomy and Fusion Procedures in the Adult Population: A Propensity Score-Matched Study"],"prefix":"10.31616","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9371-1623","authenticated-orcid":true,"given":"Adrian John","family":"Rodrigues","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-1787","authenticated-orcid":true,"given":"Kunal","family":"Varshneya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6417-1787","authenticated-orcid":true,"given":"Martin Nikolaus","family":"Stienen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7633-0450","authenticated-orcid":true,"given":"Ethan","family":"Schonfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khoi Duc","family":"Than","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Veeravagu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16744","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e3181bef3cb"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2017.10.072"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-200504000-00007"},{"key":"ref4","first-page":"2138","volume-title":"Long-term results after anterior cervical discectomy and fusion with allograft and plating: a 5- to 11-year radiologic and clinical follow-up study","author":"Yue","year":"2005"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.85.2.0206"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/brs.0b013e31821cbba5"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2009.05.006"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200301150-00008"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2016.05.01"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1177\/2192568217699200"},{"key":"ref11","first-page":"57","volume-title":"Geographic variation in the surgical treatment of degenerative cervical disc disease: American Board of Orthopedic Surgery quality improvement initiative; 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