A cost analysis of two anterior cervical fusion procedures

Multilevel anterior cervical discectomy and fusion (ACDF) remains a difficu lt problem. A recently described surgical technique for multilevel ACDF has eliminated the morbid complications associated with harvesting iliac crest bone graft (ICBG) while maintaining the advantages of using autologous bon e graft. A matched-pairs t test was used to compare the estimated costs of 27 ACDFs using titanium surgical mesh, local autologous bone graft, and ant erior plate instrumentation with 27 ACDFs using ICBG and plate fixation. Th e three variables. considered were cage cost, operating time (cost), and ho spitalization cost. The estimated costs for the two surgical procedures wer e not significantly different. Thus, the time saved by not harvesting an IC BG was comparable to the cost of the cage. Harvesting ICBG also increased t he morbidity rate by 22%.