Anterior Cervical Discectomy and Fusion Versus Cervical Disc Arthroplasty
Bibliographic record
Abstract
STUDY DESIGN: Epidemiologic study using national administrative data. OBJECTIVE: To compare anterior cervical discectomy and fusion (ACDF) with cervical disc arthroplasty (CDA) for the treatment of cervical disc pathology in terms of (1) patient and hospital characteristics, length of stay, and total charges; and (2) temporal changes in those variables and in overall numbers. SUMMARY OF BACKGROUND DATA: Studies have shown that CDA has results and safety profiles comparable with those of ACDF, but information on patient and hospital characteristics and economical impact of CDA is lacking. METHODS: We queried the Nationwide Inpatient Sample for all hospitalization records from 2005 through 2008 with International Classification of Diseases, Ninth Revision, Clinical Modification codes corresponding to ACDF or CDA, used multivariable linear regression analyses (significance, P, 0.05) for patient and hospital characteristics, and calculated length of stay parameters. For total hospital charges, we used the consumer price index to convert all charges to 2008 US dollars. RESULTS: Most of the 544,174 ACDF procedures occurred in the South; most of the 4,710 CDA procedures occurred in the West and South. Compared with patients undergoing ACDF, those undergoing CDA were younger (P, 0.001). Comorbid severity for ACDF increased over time (P, 0.001) but did not change for CDA (P = 0.664). Although hospital stay decreased for both groups, total hospital charges increased for ACDF but remained stable for CDA over time. CONCLUSION: Patients undergoing CDA tended to be younger and to have less comorbidity, shorter hospital stays, and lower costs. The number of CDAs increased over time, although the percentage remained relatively small in comparison with that for ACDF.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".