Our Summary

This research study looks at the cost differences between two types of surgery procedures used to treat a condition affecting the neck called cervical myelopathy. The two procedures are called posterior cervical laminectomy with fusion (LF) and cervical laminoplasty (LP).

The researchers looked at past records of 277 LP procedures and 229 LF procedures performed between 2019 and 2023. They calculated the total facility costs, including the cost of staff and supplies, for each procedure using a special method called time-driven activity-based costing (TDABC). They also did some calculations with and without the cost of the implants used in the surgeries.

The results showed that the LP procedure had lower costs in terms of supplies and staff, resulting in a lower total cost for the facility, whether the cost of the implant was included or not. Even after considering factors like patient demographics and other health problems, the LF procedure still had higher total facility costs.

This suggests that the LP procedure may be a less costly and more efficient option for treating cervical myelopathy.

FAQs

  1. What are the two types of surgery procedures used to treat cervical myelopathy studied in this research?
  2. How were the total facility costs for the posterior cervical laminectomy with fusion (LF) and cervical laminoplasty (LP) procedures calculated in this study?
  3. According to the research, which procedure between LF and LP had lower total facility costs?

Doctor’s Tip

A doctor might tell a patient considering a spinal laminectomy that based on research, a cervical laminoplasty (LP) procedure may be a more cost-effective option compared to a posterior cervical laminectomy with fusion (LF). This information could help the patient make an informed decision about their treatment plan.

Suitable For

Patients who are typically recommended for spinal laminectomy procedures such as posterior cervical laminectomy with fusion (LF) or cervical laminoplasty (LP) are those suffering from conditions such as cervical myelopathy, which is a condition that affects the spinal cord in the neck. Symptoms of cervical myelopathy can include weakness, numbness, and coordination problems in the arms and legs.

Patients who have not responded to conservative treatments such as physical therapy or medication may be recommended for spinal laminectomy procedures. Additionally, patients who have spinal cord compression or spinal stenosis (narrowing of the spinal canal) may also be candidates for these procedures.

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine the most appropriate treatment option for their specific condition. Factors such as the severity of symptoms, the extent of spinal cord compression, and overall health status will all be taken into consideration when determining whether a spinal laminectomy procedure is appropriate.

Timeline

Before spinal laminectomy:

  • Patient experiences symptoms of cervical myelopathy, such as neck pain, weakness, numbness, and tingling in the arms and hands
  • Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis
  • Patient and healthcare provider discuss treatment options, including spinal laminectomy
  • Patient undergoes pre-operative evaluations and tests to ensure they are a good candidate for surgery

After spinal laminectomy:

  • Patient undergoes spinal laminectomy surgery to relieve pressure on the spinal cord and nerves
  • Patient is monitored closely post-operatively for any complications
  • Patient may need physical therapy or rehabilitation to regain strength and function in the affected areas
  • Patient follows up with their healthcare provider for post-operative care and monitoring of symptoms
  • Over time, patient experiences relief from symptoms and improved function in the affected areas

In conclusion, spinal laminectomy can be an effective treatment option for cervical myelopathy, leading to improved outcomes and quality of life for patients.

What to Ask Your Doctor

  1. What is the difference between posterior cervical laminectomy with fusion (LF) and cervical laminoplasty (LP) in terms of procedure and recovery?

  2. What are the potential risks and complications associated with each procedure?

  3. How long is the recovery time for each procedure and what can I expect during the recovery process?

  4. Are there any specific criteria that make me a better candidate for one procedure over the other?

  5. What are the long-term outcomes and success rates of each procedure for treating cervical myelopathy?

  6. Will I need physical therapy or additional treatments after the surgery?

  7. How many times have you performed each procedure and what is your success rate with these surgeries?

  8. What are the potential costs involved with each procedure, including facility costs, implants, and other associated expenses?

  9. Are there any alternative treatment options for cervical myelopathy that I should consider before deciding on surgery?

  10. How should I prepare for the surgery and what can I do to optimize my chances for a successful outcome?

Reference

Authors: Chua T, Lim PL, Hershman SH, Fogel HA, Tobert DG. Journal: Spine (Phila Pa 1976). 2024 Nov 15;49(22):1555-1560. doi: 10.1097/BRS.0000000000005150. Epub 2024 Sep 5. PMID: 39235085