February 3, 2011
What an opportunity! In 2007, CMS moved artificial disc replacement from DRG 500 ($4,962) to 490 ($8,542), representing a reimbursement increase of over 40%. This increase, combined with lower costs through discounting, has played a major role in a market projected to grow from $55 million in 2007 to $440 million by 2013.
Although new technologies, such as nucleus repair devices, have helped extend the life of spinal discs, over 200,000 spinal surgeries are still performed each year. Artificial discs (CHARITÉ), first FDA approved in 2004, are an alternative to spinal fusion, and clinical trials have shown that there is no statistical difference between artificial discs and anterior lumbar interbody fusion. Studies revealed that the overall success rate was 57.8% for artificial discs versus 51.2% for anterior lumbar interbody fusion, and patient satisfaction was also similar at 78% versus 72%, respectively. However, data indicated that artificial disc patients recovered faster and returned to normal life sooner than fusion procedures.
I spoke with Joseph Dryer, MD, assistant professor of orthopedic surgery and neurosurgery at New York University Medical Center in New York, NY, a spinal surgery expert, and widely published author about the advantages of artificial discs. He stated, There is a fairly large market potential for this technology considering how many people in the US have back pain. The patients see immediate results from pain relief and mobility comes back fairly soon. Furthermore, the total length of stay is about a day; a fusion procedure requires about one to two days in the hospital. Furthermore, the implant is less than the hardware for pedicle screws and rods, and you do not have the costs of the bone cement.
With information more readily available, spinal patients face a challenging decision. Both technologies offer similar outcomes and costs, but one compelling benefit to artificial discs is that they allow patients to recover faster, enabling them to return to work sooner.
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