Surprisingly, spinal fusion costs roughly 20% to 30% more than a single level artificial disc replacement.
Artificial disc replacement is usually a better deal. To begin with, artificial disc replacement is less expensive than spinal fusion. Second, artificial disc replacement has a faster recovery time than spinal fusion. Third, and perhaps most importantly, individuals with artificial disc replacement had greater spinal mobility than those with spinal fusion. Fourth, research suggest that ADR is far less expensive in the long run than fusion.
The expense of artificial disc replacement surgery is covered by most insurance carriers, but not all. As a result, it’s critical to find out if the expense of artificial disc replacement surgery is covered by your health insurance provider and policy. Find out what your deductibles are as well.
Yes, same-day surgery is far less expensive than hospital-based surgery. Same-day surgery, on the other hand, is not always possible. If you are at risk for problems (older age, diabetes, smoking, high blood pressure, obesity, etc. ), hospitalization for initial recovery is usually the safer alternative, regardless of cost.
Many spine surgeons provide payment plans to help people spread the cost of artificial disc replacement surgery over a longer period of time. This is especially crucial if the procedure’s cost is not covered by insurance. Inquire about payment plans or low-interest loans when discussing costs with your surgeon’s office.
Does insurance cover fake disc replacement?
Although the United States Food and Drug Administration has approved numerous artificial disc replacement (ADR) devices for the lower (lumbar) spine, this operation is not covered by all health insurance policies. Some health insurance companies, on the other hand, still consider lumbar disc replacement to be an experimental operation.
How much does it cost to replace a disc in your back?
The cost of anterior disc replacement (ADR) surgery varies based on where you live, as it does with other procedures. It costs around $45,000 on average, but in places like New York or Boston, it can cost up to $100,000, or 80-85% of the cost of a spinal fusion. The hospital stay, implant, surgeon, and anesthesiologist are all included in the price.
Some people prefer to have their M6 disc replaced in Germany. The cost of M6 surgery is normally roughly $35,000, but patients must also pay for travel, which involves making their own arrangements for a three-week stay in Germany. Finally, the cost of this treatment is comparable to the cost of artificial disc replacement surgery in the United States.
Is disc replacement major surgery?
The replacement of a lumbar disk is a sort of back or spine surgery. The bones in your spine are called vertebrae, and they are piled on top of each other. The disks between the vertebrae act as cushions, allowing the vertebrae to move and rotate without rubbing against one another. At the bottom of your spine are the lumbar vertebrae and disks. A damaged or deteriorated disk in the lower region of your spine is replaced with an artificial disk made of metal or a combination of metal and plastic.
Lumbar disk replacement is frequently recommended as an alternative to spinal fusion surgery. Fusion is a surgical procedure that permanently unites two vertebrae together. Lumbar disk replacement is a complex procedure that necessitates general anesthesia as well as a stay in the hospital.
What is the success rate of disc replacement surgery 2020?
According to Dr. Phillips, who is Professor, Director, Section of Minimally Invasive Spine Surgery, and Director, Division of Spine Surgery, Rush University Medical Center, early two-year follow-up data on a variety of artificial disc devices show “highly significant improvements in neck and arm pain scores in both the artificial disc and ACDF groups.”
He stated, “Evidence also supports a low reoperation rate with disc replacement at two years, with the same pattern reported across various disc designs.” Furthermore, evidence suggests that disc replacement slows the progression of neighboring segment degeneration. 1-3 According to Dr. Phillips, rates of radiographic adjacent level illness range from 10.1 percent to 26.7 percent with artificial disc replacement and from 23.1 percent to 44.4 percent with ACDF in recent investigations. 1-3
Furthermore, the findings imply that cervical disc replacement is comparable to hip and knee replacement surgery. In a research comparing cervical disc replacement to hip/knee joint replacement surgery, patients receiving hip and knee replacement had worse baseline physical function, whereas individuals undergoing cervical arthroplasty had worse mental health scores. 4 However, after cervical disc replacement, the improvement in physical component score was much better than after ACDF or hip/knee replacement.
Long-Term Disc Replacement Outcomes
Artificial disc replacement appears to provide long-term benefits, with 7-year follow-up studies supporting artificial disc replacement versus ACDF in terms of secondary surgery rates. 5-8
“We consistently see an approximately one-third reduced reoperation rate in favor of disc replacement over ACDF across different designs, multiple sites, and different authors reporting the data when we look at 7-year data from a range of disc prostheses,” Dr. Phillips stated.
Kaplan-Meier survivorship analysis reveals that as patients are followed for extended periods of time, the graphs diverge in favor of disc replacement over ACDF, according to a 7-year follow-up study by Dr. Phillips and colleagues. “And, in the end, that difference in the graph is what drives cost and gives value for the treatment, according to Dr. Phillips. 8
Furthermore, a prospective, randomized trial comprising 128 patients who had complete disc replacement and 104 patients who had ACDF indicated that the disc replacement group’s overall success rate was significantly greater, at 81 percent against 66 percent with ACDF (P=0.005).
9 At ten years, the disc replacement group had a lower rate of secondary surgery at adjacent levels (10 percent versus 16 percent with ACDF), although the difference was not statistically significant (P=0.146). The Neck Disability Index (NDI) ratings and visual analog scale (VAS) neck and arm discomfort showed a similar pattern, and range of motion at the disc replacement level was maintained at 10 years in the disc replacement group, according to Dr. Phillips.
Differences Between US and European Outcomes Studies
Dr. Phillips added that credible randomized controlled trials, systematic reviews, and meta-analyses involving both 1- and 2-level C-ADR undertaken in the United States have indicated that C-ADR is more effective than ACDF.
According to Dr. Phillips, a recent European study by MacDowell et al indicated that patients with cervical degenerative disc degeneration and radiculopathy who received total disc replacement did not have better clinical or radiological results after 5 years when compared to those who underwent ACDF.
10
“We all need to take a hard look at what we’re doing and question why the European experience differs from the American one.” According to Dr. Phillips. “It’s simple to blame the disparities in results on surgeon and industry bias, but I believe those biases fade away after 7 and 10 years. Is it a difference in patient selection, surgical technique, surgeon experience, or the usage of prosthesis not available in the United States?”
While the cause of the gap is unknown, Dr. Phillips stressed that it is a problem that must be addressed. Dr. Phillips went on to say that a 2019 independent evaluation by Health Quality Ontario is “extremely telling” because the organization “has no motive to fund procedures.” 11
With a moderate grade of evidence, the Health Quality Ontario review found eight studies of 1-level cervical degenerative disc disease and two studies of 2-level cervical degenerative disc disease that met the criteria for statistical non-inferiority of total disc replacement compared to ACDF on the primary outcome of 2-year overall treatment success.
11 In two investigations of patients with two levels of illness, cervical artificial disc replacement outperformed ACDF in terms of total treatment success. Furthermore, at the index level, artificial disc replacement outperformed ACDF in terms of recovery and return to work, as well as lower rates of reoperation.
Furthermore, the researchers found that cervical artificial disc replacement is likely to be more cost-effective than ACDF for both 1-level ($11,607/QALY) and 2-level ($16,782/QALY) disc degeneration when compared to ACDF.
11
Next Generation Artificial Discs
While first-generation artificial discs were created utilizing ball-and-socket technology similar to that used in hip and knee replacement, none of the devices, according to Dr. Phillips, properly reproduce the natural disc kinematics. The goal of next-generation designs is to produce a device that mimics the natural disc’s physiology.
The M6-C Artificial Cervical Disc, which was approved by the United States Food and Drug Administration (FDA) in February 2019, is one such design.
12 Statistically significant improvements in NDI and VAS neck pain and shoulder/arm pain were found with the M6-C Artificial Cervical Disc versus ACDF at every time point during the 2-year follow-up period in a prospective, concurrently controlled multicenter FDA investigational device exemption trial of the M6-C device. 12 According to Dr. Phillips, the positive results could be due to the device’s unique design.
Extended Indications: The Hybrid Concept
Patients with 2-level cervical disc disease may benefit from cervical artificial disc replacement combined with ACDF (hybrid surgery), according to the findings.
Hybrid surgery was found to be superior than 2-level ACDF in terms of NDI recovery, post-operative neck pain, C2-C7 range of motion recovery, and adjacent level motion in a research by Shin et al.
13 Furthermore, Dr. Phillips and colleagues discovered that cervical disc replacement is a viable surgical option when performed next to earlier fusions in a study. 14
“The results of cervical disc replacement following adjacent level ACDF were equal to those of primary procedures,” Dr. Phillips remarked.
Patient Selection is Key
Total disc replacement complications could be linked to poor patient selection, according to Dr. Phillips. Pre-operative instability on dynamic flexion-extension imaging; systemic bone illness (osteoporosis, rheumatoid arthritis, metabolic bone disease); or spondylotic myelopathy are all contraindications (discussion of severity ongoing).
Conclusion
“Dr. Phillips said, “Cervical disc replacement is one of the most evidence-based treatments in spine surgery.” “In comparison to ACDF, we have level 1 evidence suggesting that cervical disc replacement lowers neighboring segment degeneration. “Disc replacement is related with a lower rate of reoperation than ACDF, and this difference grows as we follow these patients for extended periods of time.”
- TheraCell, Vital 5, EDGe Surgical, Providence Medical Technology, Vertiflex, Surgio, International Society for the Advancement of Spine Surgery, Society for Minimally Invasive Spine Surgery, International Society for the Advancement of Spine Surgery, International Society for the Advancement of Spine Surgery, International Society for the Advancement of Spine Surgery, International Society for the Advancement of Spine Surgery, International Society for the Advancement of Spine Surgery, International Society for the Advancement of Spine
How much does disc surgery cost?
A laminectomy, which is commonly conducted to cure spinal stenosis, costs $50,000 to $90,000 for people who do not have health insurance. Fortunately, most health insurance policies include back surgery if it is recommended by a doctor. Most insurance plans cover spinal surgery, and Medicare covers back surgery in most cases. If the deductible has been reached, typical out-of-pocket costs for patients insured by insurance would be a co-insurance payment of between 10% and 40% of the procedure, for a total of $200 to $2,000 or more, up to the yearly out-of-pocket maximum.
A herniated disc operation that isn’t covered by insurance can cost anywhere from $20,000 to $50,000, depending on the surgeon, anesthesiologist, and facility fees. A minimally invasive outpatient microdiscectomy is on the low end of the spectrum, while an inpatient open discectomy with a hospital stay is on the high end. If ordered by a doctor, herniated disc surgery is usually covered by health insurance. If the deductible has been reached, typical out-of-pocket costs for patients insured by insurance would be a co-insurance payment of between 10% and 40% of the procedure, for a total of around $2,000, up to the yearly out-of-pocket maximum.
A spinal fusion, which is often done to treat issues such as a slipped vertebrae or other spinal instability, normally costs between $80,000 and $150,000 for those without health insurance, and sometimes even more! A procedure that uses high-end titanium implants instead of a donor’s bone is usually more expensive. Fortunately, the operation would cost around $5,000 depending on your insurance.
How long is recovery for disc replacement surgery?
Artificial disc replacement recovery period is about 3-5 weeks on average; however, it varies from patient to patient. Many patients can return to modest exercises and desk work within a week, but others may need up to three months to reach their maximum activity level. Importantly, because the vertebrae do not have to fuse together following artificial disc replacement surgery, recovery time is quicker than after spinal fusion surgery. Learn more about the differences between disc replacement and spinal fusion in our disc replacement versus spinal fusion tutorial.
Artificial Disc Replacement Surgery
What is artificial disc replacement, and how does it work? To address one level of illness, an artificial disc replacement procedure takes 45 minutes to 1:15 minutes at most. A professional spine surgeon removes your injured natural vertebral disc from the spinal column before performing artificial disc replacement surgery. For the first few days after a cervical disc replacement, you may need low-dose opioids, but most patients can manage post-surgery discomfort at home with acetaminophen, ibuprofen, or naproxen.
There are many various forms of artificial disc replacements, but your spine surgeon will most likely change the vertebral bones above and below the disc that has been removed. The artificial disc can now be implanted in precise alignment on your spine thanks to this change. The surgeon seals the region and incision when the artificial disc is in place, and you are transferred out of the operating room and into post-anesthesia care. You may spend up to 4 hours in the surgery center once fully awake before being allowed to recover at home. This procedure is performed as an outpatient procedure.
How long does it take to recover from l4 l5 back surgery?
Your ability to recover after lumbar decompression surgery will be determined by your degree of fitness and activity before to surgery. This is why, prior to the operation, physiotherapy may be prescribed.
The day after surgery, you’ll be urged to walk and move around, and you’ll most likely be discharged 1 to 4 days later.
You should be able to return to your previous level of mobility and function in 4 to 6 weeks (this will depend on the severity of your condition and symptoms before the operation).
Your back may feel sore when you wake up following lumbar decompression surgery, and you’ll most likely be connected to one or more tubes.
- Intravenous drip: a drip that delivers fluids directly into a vein to keep you hydrated.
- If you have trouble peeing, you may need a urinary catheter, which is a thin, flexible tube put into your bladder.
How much does a herniated disc settlement payout for?
In California, the average workers’ compensation payment for a herniated disc can range from $40,000 to $80,000. However, in some circumstances, the settlement award can be significantly higher.
It’s worth noting that no two herniated disc cases are alike. As a result, workers’ compensation payments for these injuries will vary depending on a variety of criteria, including:
A workers’ compensation settlement is, in general, an agreement on the amount of workers’ compensation benefits that will be paid to an injured worker. These advantages can be in the form of:
When a wounded claimant agrees to pay the cash worth of his or her future care, the agreement might be written in one of two ways:
Who is not a candidate for disc replacement?
Cervical disc replacement is a procedure that is performed to treat symptomatic cervical disc disease that has not responded to nonsurgical treatment. While disc replacement (arthroplasty) can usually be utilized instead of an anterior cervical discectomy and fusion in most cases, arthroplasty isn’t always an option. Disc replacement is currently only allowed for use at one cervical level in the United States, and it is not permitted for use next to a previous cervical fusion. The technique should not be conducted on children or when the afflicted level has aberrant motion or instability. The use of a disc replacement device is also prohibited by advanced degenerative changes known as spondylosis affecting the facet joints in the back of the spine at the afflicted level. In addition, a disc replacement device should not be utilized if you have severe osteoporosis or an active infection. It’s vital to remember that cervical arthroplasty is a very new and technically difficult treatment whose exact indications are still evolving. Patients should consult with a trained spine surgeon to evaluate if disc replacement is a viable choice for their situation.
Cervical disc replacement surgery has risks that are quite comparable to those associated with anterior cervical discectomy and fusion surgery. Nerve injury is an incredibly unusual consequence of this and most other spinal operations, but it is a potentially fatal one. With cervical disc replacement, bleeding is usually minimal, and the risk of infection is likewise minimal. Swallowing problems are frequent after any anterior cervical surgery, but they usually go away on their own. Technical issues with the disc replacement device, such as a poorly positioned implant or device movement after implantation, are conceivable and may necessitate revision surgery. Spontaneous fusion across the level of the disc replacement has been documented, however it usually does not require treatment.
Many doctors and patients have raised concern about the disc replacement device’s long-term durability. Fortunately, unlike hip and knee replacements, cervical arthroplasty devices have not been observed to cause this. This is most likely due to the fact that the forces placed on these implants are far lower than those placed on other joints like the hip and knee. Furthermore, the biologic milieu of the disc space differs significantly from that of the joints in the extremities. There are several other potential risks with the surgery, and a comprehensive conversation with your physician is required before proceeding with this or any other surgical procedure.
Cervical Disc Replacement has a high success rate, and recovery times are frequently shorter than fusion. The operation is intended to alleviate discomfort and improve function while also preventing additional neurologic impairment. Following surgery, most patients report a gradual improvement in pain and function. The majority of patients will not detect a reduction in neck range of motion.