title: Anterior cervical discectomy and fusion versus cervical disc arthroplasty: current state and trends in treatment for cervical disc pathology.
abstract: METHODS
  Epidemiologic study using national administrative data.
  
  
  OBJECTIVE
  To compare anterior cervical discectomy and fusion (ACDF) with cervical disc arthroplasty (CDA) for the treatment of cervical disc pathology in terms of (1) patient and hospital characteristics, length of stay, and total charges; and (2) temporal changes in those variables and in overall numbers.
  
  
  BACKGROUND
  Studies have shown that CDA has results and safety profiles comparable with those of ACDF, but information on patient and hospital characteristics and economical impact of CDA is lacking.
  
  
  METHODS
  We queried the Nationwide Inpatient Sample for all hospitalization records from 2005 through 2008 with International Classification of Diseases, Ninth Revision, Clinical Modification codes corresponding to ACDF or CDA, used multivariable linear regression analyses (significance, P, 0.05) for patient and hospital characteristics, and calculated length of stay parameters. For total hospital charges, we used the consumer price index to convert all charges to 2008 US dollars.
  
  
  RESULTS
  Most of the 544,174 ACDF procedures occurred in the South; most of the 4,710 CDA procedures occurred in the West and South. Compared with patients undergoing ACDF, those undergoing CDA were younger (P, 0.001). Comorbid severity for ACDF increased over time (P, 0.001) but did not change for CDA (P = 0.664). Although hospital stay decreased for both groups, total hospital charges increased for ACDF but remained stable for CDA over time.
  
  
  CONCLUSIONS
  Patients undergoing CDA tended to be younger and to have less comorbidity, shorter hospital stays, and lower costs. The number of CDAs increased over time, although the percentage remained relatively small in comparison with that for ACDF.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave., Baltimore, MD 21224, USA.
authors.forename: Sergiy O
authors.initials: SO
authors.lastname: Nesterenko
authors.forename: Lee H
authors.initials: LH
authors.lastname: Riley
authors.forename: Richard L
authors.initials: RL
authors.lastname: Skolasky
mesh_terms: D001178:Arthroplasty / Q000706:statistics & numerical data*; D002574:Cervical Vertebrae / Q000601:surgery*; D017586:Diskectomy / Q000706:statistics & numerical data*; D005260:Female; D005843:Geography; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D055959:Intervertebral Disc Degeneration / Q000453:epidemiology / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery; D007902:Length of Stay / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology