The value of disk replacement

Abstract The high costs associated with spine surgery underlie the increasing importance to evaluate new treatments such as disc replacement. In order to prove their value as a surgical modality in spine surgery, both clinical efficacy and cost-analysis data must be examined closely. Efficacy data shows promising short-term results for both cervical and lumbar disc replacement. However, cost data remains scarce for both treatments. In this review of the literature, there were seven studies evaluating cost, three of which calculated quality-adjusted life-years (QALY), and only one that calculated incremental cost-effectiveness ratios (ICER). The short-term data suggests that both cervical and lumbar disc replacement are less costly than fusion for single-level disease. Further long-term cost data is necessary to better elucidate the true value of disc replacement and whether it should be accepted as a standard alternative to fusion.