Cervical Arthroplasty Cost Effectiveness Study (CACES)

Launched by VALÉRIE SCHUERMANS · Nov 9, 2020

Keywords

ClinConnect Summary

The Cervical Arthroplasty Cost Effectiveness Study (CACES) is examining which surgical method is more cost-effective for treating certain neck conditions caused by degenerative disc disease. Patients with symptoms like pain, weakness, or numbness in their arms due to issues in the cervical spine (the neck region) will be randomly assigned to receive one of two types of surgery: anterior cervical discectomy with fusion (ACDF), which involves removing the damaged disc and fusing the vertebrae together, or anterior cervical discectomy with arthroplasty (ACDA), which replaces the disc with an artificial one while preserving movement. The study aims to determine not only the costs associated with these procedures but also their effectiveness over time.

To be eligible for this trial, participants must be adults aged 18 or older with specific symptoms related to cervical disc disease that have not improved with conservative treatments for at least six weeks. They should not have had previous surgeries on their cervical spine or certain other medical conditions that could complicate the surgery. Participants can expect to be monitored for clinical and radiological outcomes at the start of the study and every six months for up to four years after their surgery. This study is particularly important as it addresses the rising healthcare costs and aims to provide valuable information on the best surgical options for patients dealing with these common neck issues.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Indication for anterior cervical decompression surgery.
• • Single- or multilevel CDDD between C3 and C7.
• • Symptoms of myelopathy, radiculopathy, or myeloradiculopathy.
• • In case of pure radiculopathy: refractory to at least 6 weeks of conservative therapy.
• • In case of myelopathy: symptomatic myelopathy.
• • Patients ≥ 18 years of age.
• • Exclusion criteria
• • Indication for (additional) posterior surgical approach.
• • Indication for additional stabilization of the pathological segment by a plate.
• • Previous ventral surgery of the cervical spine.
• • Traumatic origin of the compression.
• • Previous radiotherapy of the cervical spine.
• • Metabolic bone disease.
• • Inflammatory spinal disease: e.g., Bechterew's disease, Forestier's disease.
• • Infection of the cervical spine.