{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T13:21:13Z","timestamp":1780060873932,"version":"3.54.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Long-term meta-analysis of cervical disc arthroplasty (CDA) trials report lower rates of subsequent cervical spine surgical procedures with CDA compared with anterior cervical discectomy and fusion (ACDF). The objective of this study was to compare the rate of subsequent cervical spine surgery in single-level CDA\u2013treated patients to that of a matched cohort of single-level ACDF\u2013treated patients by using records from 2010 to 2021 included in a large national administrative claims database (PearlDiver).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective matched-cohort study used a large national insurance claims database; 525,510 patients who had undergone a single-level ACDF or CDA between 2010 and 2021 were identified. Patients with other same-day spine procedures, as well as those for trauma, infection, or tumor, were excluded, yielding 148,531 patients. ACDF patients were matched 2:1 to CDA patients on the basis of clinical and demographic characteristics. The primary outcome was the overall incidence of all-cause cervical reoperation after index surgery. Secondary outcomes included readmission, any adverse event within 90 days, and overall reintervention after index surgery. Multivariable logistic regression analyses were adjusted for covariates and were employed to estimate the effect of the index ACDF or CDA procedure on patient outcomes. Survival was assessed using Kaplan-Meier estimation, and differences between ACDF- and CDA-treated patients were compared using log-rank tests.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>After the patients were matched, 28,795 ACDF patients to 14,504 CDA patients were included. ACDF patients had higher rates of 90-day adverse events (18.4% vs 14.6%, adjusted odds ratio [aOR] 0.77, 95% CI 0.73\u20130.82, p &lt; 0.001) and readmission (11.5% vs 9.7%, aOR 0.87, 95% CI 0.81\u20130.93, p &lt; 0.001). Over a mean 4.3 years of follow-up, 5.0% of ACDF patients and 5.4% of CDA patients underwent reoperation (aOR 1.09, 95% CI 1.00\u20131.19, p = 0.059). The rate of aggregate reintervention was higher in CDA patients than in ACDF patients (11.7% vs 10.7%, aOR 1.10, p = 0.002). The Kaplan-Meier 10-year reoperation-free survival rate was worse for CDA than ACDF (91.0% vs 92.0%, p = 0.05), as was the rate of reintervention-free survival (81.2% vs 82.0%, p = 0.003).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Single-level CDA was associated with a similar rate of reoperation and higher rate of subsequent injections when compared with a matched cohort that underwent single-level ACDF. CDA was associated with lower rates of 90-day adverse events and readmissions.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.10.spine23640","type":"journal-article","created":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T01:58:14Z","timestamp":1702691894000},"page":"282-290","source":"Crossref","is-referenced-by-count":8,"title":["Is single-level cervical disc arthroplasty associated with a lower reoperation rate than anterior cervical discectomy and fusion?"],"prefix":"10.3171","volume":"40","author":[{"given":"Alexander","family":"Tuchman","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Chen","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey T.","family":"Walker","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda E.","family":"Kanim","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun W.","family":"Bae","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Skaggs","sequence":"additional","affiliation":[{"name":"Departments of Orthopedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Orthop Surg","first-page":"16","article-title":"Long-term results comparing cervical disc arthroplasty to anterior cervical discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Wang QL","year":"2020","unstructured":"Wang QL, Tu ZM, Hu P,  Long-term results comparing cervical disc arthroplasty to anterior cervical discectomy and fusion: a systematic review and meta-analysis of randomized controlled trials. Orthop Surg. 2020;12(1):16\u201330."},{"issue":"9","key":"b2","series-title":"J Bone Joint Surg Am","first-page":"1298","article-title":"Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients","volume":"75","author":"Bohlman HH","year":"1993","unstructured":"Bohlman HH, Emery SE, Goodfellow DB, Jones PK. Robinson anterior cervical discectomy and arthrodesis for cervical radiculopathy. Long-term follow-up of one hundred and twenty-two patients. J Bone Joint Surg Am. 1993;75(9):1298\u20131307."},{"issue":"4","key":"b3","series-title":"J Bone Joint Surg Am","first-page":"519","article-title":"Radiculopathy and myelopathy at segments adjacent to the site of a previous anterior cervical arthrodesis","volume":"81","author":"Hilibrand AS","year":"1999","unstructured":"Hilibrand AS, Carlson GD, Palumbo MA, Jones PK, Bohlman HH. 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Secondary surgery after cervical disc arthroplasty versus fusion for cervical degenerative disc disease: a meta-analysis with trial sequential analysis. Orthop Surg. 2018;10(3):181\u2013191."},{"issue":"5","key":"b14","series-title":"Clin Orthop Relat Res","first-page":"1307","article-title":"Reoperation after cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis","volume":"474","author":"Zhong ZM","year":"2016","unstructured":"Zhong ZM, Zhu SY, Zhuang JS, Wu Q, Chen JT. Reoperation after cervical disc arthroplasty versus anterior cervical discectomy and fusion: a meta-analysis. 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Primary and revision cervical disc arthroplasty from 2010-2020: patient demographics, utilization trends, and healthcare reimbursements. World Neurosurg. 2022;168:e344\u2013e349."},{"issue":"2","key":"b18","series-title":"Diabetes Res Clin Pract","first-page":"189","article-title":"Validating ICD coding algorithms for diabetes mellitus from administrative data","volume":"89","author":"Chen G","year":"2010","unstructured":"Chen G, Khan N, Walker R, Quan H. Validating ICD coding algorithms for diabetes mellitus from administrative data. Diabetes Res Clin Pract. 2010;89(2):189\u2013195."},{"issue":"3","key":"b19","series-title":"J Am Acad Orthop Surg","first-page":"121","article-title":"Osteoporosis and implant-related complications after anatomic and reverse total shoulder arthroplasty","volume":"28","author":"Casp AJ","year":"2020","unstructured":"Casp AJ, Montgomery SR Jr, Cancienne JM, Brockmeier SF, Werner BC. Osteoporosis and implant-related complications after anatomic and reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2020;28(3):121\u2013127."},{"issue":"4","key":"b20","series-title":"J Am Med Inform Assoc","first-page":"652","article-title":"ICD-9 tobacco use codes are effective identifiers of smoking status","volume":"20","author":"Wiley LK","year":"2013","unstructured":"Wiley LK, Shah A, Xu H, Bush WS. ICD-9 tobacco use codes are effective identifiers of smoking status. J Am Med Inform Assoc. 2013;20(4):652\u2013658."},{"key":"b21","series-title":"World Neurosurg","first-page":"e26","article-title":"Elixhauser comorbidity measure is superior to Charlson Comorbidity Index in-predicting hospital complications following elective posterior cervical decompression and fusion","volume":"138","author":"Maron SZ","year":"2020","unstructured":"Maron SZ, Neifert SN, Ranson WA,  Elixhauser comorbidity measure is superior to Charlson Comorbidity Index in-predicting hospital complications following elective posterior cervical decompression and fusion. World Neurosurg. 2020;138:e26\u2013e34."},{"issue":"8","key":"b22","series-title":"Spine (Phila Pa 1976)","first-page":"662","article-title":"Osteoporosis in cervical spine surgery","volume":"41","author":"Guzman JZ","year":"2016","unstructured":"Guzman JZ, Feldman ZM, McAnany S, Hecht AC, Qureshi SA, Cho SK. Osteoporosis in cervical spine surgery. Spine (Phila Pa 1976). 2016;41(8):662\u2013668."},{"issue":"6","key":"b23","series-title":"Global Spine J","first-page":"1119","article-title":"Prevalence of osteoporosis treatment and its effect on post-operative complications, revision surgery and costs after multi-level spinal fusion","volume":"12","author":"Jain N","year":"2022","unstructured":"Jain N, Labaran L, Phillips FM,  Prevalence of osteoporosis treatment and its effect on post-operative complications, revision surgery and costs after multi-level spinal fusion. Global Spine J. 2022;12(6):1119\u20131124."},{"issue":"15","key":"b24","series-title":"Spine (Phila Pa 1976)","first-page":"1294","article-title":"Effect of smoking on the perioperative outcomes of patients who undergo elective spine surgery","volume":"38","author":"Seicean A","year":"2013","unstructured":"Seicean A, Seicean S, Alan N,  Effect of smoking on the perioperative outcomes of patients who undergo elective spine surgery. Spine (Phila Pa 1976). 2013;38(15):1294\u20131302."},{"issue":"1","key":"b25","series-title":"Ann Surg","first-page":"52","article-title":"Preoperative smoking status and postoperative complications: a systematic review and meta-analysis","volume":"259","author":"Gr\u00f8nkj\u00e6r M","year":"2014","unstructured":"Gr\u00f8nkj\u00e6r M, Eliasen M, Skov-Ettrup LS,  Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann Surg. 2014;259(1):52\u201371."},{"issue":"9","key":"b26","series-title":"Eur Spine J","first-page":"2434","article-title":"Higher reoperation rate following cervical disc replacement in a retrospective, long-term comparative study of 715 patients","volume":"26","author":"Skeppholm M","year":"2017","unstructured":"Skeppholm M, Henriques T, Tullberg T. Higher reoperation rate following cervical disc replacement in a retrospective, long-term comparative study of 715 patients. Eur Spine J. 2017;26(9):2434\u20132440."},{"issue":"2","key":"b27","series-title":"J Neurosurg Spine","first-page":"159","article-title":"Artificial disc replacement versus fusion in patients with cervical degenerative disc disease with radiculopathy: 5-year outcomes from the National Swedish Spine Register","volume":"30","author":"MacDowall A","year":"2018","unstructured":"MacDowall A, Skeppholm M, Lindhagen L,  Artificial disc replacement versus fusion in patients with cervical degenerative disc disease with radiculopathy: 5-year outcomes from the National Swedish Spine Register. 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Spine J. 2018;18(6):1022\u20131029."},{"key":"b29","series-title":"World Neurosurg","first-page":"e855","article-title":"Long-term comparison of health care utilization and reoperation rates in patients undergoing cervical disc arthroplasty and anterior cervical discectomy and fusion for cervical degenerative disc disease","volume":"134","author":"Kumar C","year":"2020","unstructured":"Kumar C, Dietz N, Sharma M, Wang D, Ugiliweneza B, Boakye M. Long-term comparison of health care utilization and reoperation rates in patients undergoing cervical disc arthroplasty and anterior cervical discectomy and fusion for cervical degenerative disc disease. World Neurosurg. 2020;134:e855\u2013e865."},{"issue":"6","key":"b30","series-title":"Eur Spine J","first-page":"1432","article-title":"Reoperation and complications after anterior cervical discectomy and fusion and cervical disc arthroplasty: a study of 52,395 cases","volume":"27","author":"Kelly MP","year":"2018","unstructured":"Kelly MP, Eliasberg CD, Riley MS, Ajiboye RM, SooHoo NF. Reoperation and complications after anterior cervical discectomy and fusion and cervical disc arthroplasty: a study of 52,395 cases. Eur Spine J. 2018;27(6):1432\u20131439."},{"issue":"s2","key":"b31","series-title":"Int J Spine Surg","first-page":"S29","article-title":"Patient selection in cervical disc arthroplasty","volume":"14","author":"Nunley P","year":"2020","unstructured":"Nunley P, Frank K, Stone M. Patient selection in cervical disc arthroplasty. Int J Spine Surg. 2020;14(s2):S29\u2013S35."},{"issue":"9","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"1099","article-title":"Industry support and correlation to study outcome for papers published in Spine","volume":"30","author":"Shah RV","year":"2005","unstructured":"Shah RV, Albert TJ, Bruegel-Sanchez V, Vaccaro AR, Hilibrand AS, Grauer JN. Industry support and correlation to study outcome for papers published in Spine. Spine (Phila Pa 1976). 2005;30(9):1099\u20131105."},{"issue":"5","key":"b33","series-title":"Spine J","first-page":"372","article-title":"Factors affecting reoperations after anterior cervical discectomy and fusion within and outside of a Federal Drug Administration investigational device exemption cervical disc replacement trial","volume":"12","author":"Singh K","year":"2012","unstructured":"Singh K, Phillips FM, Park DK, Pelton MA, An HS, Goldberg EJ. Factors affecting reoperations after anterior cervical discectomy and fusion within and outside of a Federal Drug Administration investigational device exemption cervical disc replacement trial. Spine J. 2012;12(5):372\u2013378."},{"issue":"5","key":"b34","series-title":"Spine J","first-page":"1133","article-title":"Spine device clinical trials: design and sponsorship","volume":"15","author":"Cher DJ","year":"2015","unstructured":"Cher DJ, Capobianco RA. Spine device clinical trials: design and sponsorship. Spine J. 2015;15(5):1133\u20131140."},{"issue":"4","key":"b35","series-title":"Eur Spine J","first-page":"1225","article-title":"The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion\u2014a prospective, single-blinded, randomized, controlled multicenter study","volume":"26","author":"Sundseth J","year":"2017","unstructured":"Sundseth J, Fredriksli OA, Kolstad F,  The Norwegian Cervical Arthroplasty Trial (NORCAT): 2-year clinical outcome after single-level cervical arthroplasty versus fusion\u2014a prospective, single-blinded, randomized, controlled multicenter study. Eur Spine J. 2017;26(4):1225\u20131235."},{"issue":"1","key":"b36","series-title":"Springerplus","first-page":"1188","article-title":"Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)","volume":"5","author":"Xie L","year":"2016","unstructured":"Xie L, Liu M, Ding F, Li P, Ma D. Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs). Springerplus. 2016;5(1):1188."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/3\/article-p282.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/3\/article-p282.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/3\/article-p282.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:16:14Z","timestamp":1733490974000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/3\/article-p282.xml"}},"subtitle":["Presented at the 2023 AANS\/CNS Joint Section on Disorders of the Spine and Peripheral Nerves"],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":36,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2023.10.spine23640","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,1]]}}}