Evidence map›Paper›PMID 38847818›Full record

Trial reportEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2024

Cost-effectiveness of posterior versus anterior surgery for cervical radiculopathy: results from a multicentre randomised non-inferiority trial (FACET).

A E H Broekema, N F Simões de Souza, R J M Groen, R Soer, M F Reneman, J M A Kuijlen, A D I van Asselt, FACET investigators

Abstract readMulticenter StudyRandomized Controlled TrialEquivalence Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

A E H BroekemaDepartment of Neurosurgery, University Medical Centre Groningen, University of Groningen, Postal Box 30.001, 9700 RB, Groningen, The Netherlands. a.e.h.broekema@umcg.nl.ORCID http://orcid.org/0000-0002-2657-7540
N F Simões de SouzaDepartment of Neurosurgery, University Medical Centre Groningen, University of Groningen, Postal Box 30.001, 9700 RB, Groningen, The Netherlands.
R J M GroenDepartment of Neurosurgery, University Medical Centre Groningen, University of Groningen, Postal Box 30.001, 9700 RB, Groningen, The Netherlands.
R SoerDepartment of Anaesthesiology, Groningen Pain Centre, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
M F RenemanDepartment of Rehabilitation, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
J M A KuijlenDepartment of Neurosurgery, University Medical Centre Groningen, University of Groningen, Postal Box 30.001, 9700 RB, Groningen, The Netherlands.
A D I van AsseltDepartment of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
FACET investigators

Funding

ZonMw 843002604
6 · The paper itself

Abstract

purposeFor cervical nerve root compression, anterior cervical discectomy with fusion (anterior surgery) or posterior foraminotomy (posterior surgery) are safe and effective options. Posterior surgery might have a more beneficial economic profile compared to anterior surgery. The purpose of this study was to analyse if posterior surgery is cost-effective compared to anterior surgery.

methodsAn economic evaluation was performed as part of a multicentre, noninferiority randomised clinical trial (Foraminotomy ACDF Cost-effectiveness Trial) with a follow-up of 2 years. Primary outcomes were cost-effectiveness based on arm pain (Visual Analogue Scale (VAS; 0-100)) and cost-utility (quality adjusted life years (QALYs)). Missing values were estimated with multiple imputations and bootstrap simulations were used to obtain confidence intervals (CIs).

resultsIn total, 265 patients were randomised and 243 included in the analyses. The pooled mean decrease in VAS arm at 2-year follow-up was 44.2 in the posterior and 40.0 in the anterior group (mean difference, 4.2; 95% CI, - 4.7 to 12.9). Pooled mean QALYs were 1.58 (posterior) and 1.56 (anterior) (mean difference, 0.02; 95% CI, - 0.05 to 0.08). Societal costs were €28,046 for posterior and €30,086 for the anterior group, with lower health care costs for posterior (€12,248) versus anterior (€16,055). Bootstrapped results demonstrated similar effectiveness between groups with in general lower costs associated with posterior surgery.

conclusionIn patients with cervical radiculopathy, arm pain and QALYs were similar between posterior and anterior surgery. Posterior surgery was associated with lower costs and is therefore likely to be cost-effective compared with anterior surgery.

Indexed as

Cervical VertebraeCost-Benefit AnalysisDiskectomyRadiculopathySpinal FusionAdultAgedFemaleForaminotomyHumansMaleMiddle AgedQuality-Adjusted Life YearsTreatment OutcomeAnterior cervical discectomy and fusionCervical radiculopathyCost-effectivenessHealth economicsPosterior cervical foraminotomyRandomised controlled trial

Identifiers

PMID38847818
PMCPMC12611986

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.