Cost-effectiveness of surgery for degenerative cervical myelopathy in the United Kingdom
Published research co-authored by Mr Gordan Grahovac
This study looked at the cost-effectiveness of surgery for degenerative cervical myelopathy in the UK. It is relevant because DCM can affect mobility, hand function and independence, and health systems need evidence on both outcomes and value.
Research snapshot
Article title: Cost-effectiveness of surgery for degenerative cervical myelopathy in the United Kingdom
Authors: Edward Goacher, Stefan Yardanov, Richard Phillips, Alexandru Budu, Edward Dyson, Marcel Ivanov, Gary Barton, Mike Hutton, Adrian Gardner, Nasir A Quraishi, Gordan Grahovac, Josephine Jung, Andreas K Demetriades, Pierluigi Vergara, Erlick Pereira, Vasileios Arzoglou, Jibin Francis, Rikin Trivedi, Benjamin M Davies, Mark R N Kotter
Publication type: Journal article
Publication date: 26 April 2024
Publication details: British Journal of Neurosurgery. 2025;39(6):776-780.
PMID: 38712620
PMCID:
DOI: 10.1080/02688697.2024.2346566
Study type: Health economic analysis
Mr Grahovac’s involvement: Listed author on the publication
Original publication: View the original publication on PubMed
What this paper looked at
This publication examined degenerative cervical myelopathy, a condition caused by compression of the spinal cord in the neck. It considered the costs and cost-effectiveness of surgical management in a UK context.
Key points from the publication
The indexed publication record confirms the article topic, journal and DOI. Detailed cost-effectiveness figures should be checked in the full paper before being quoted in patient-facing copy.
Clinical relevance
The paper is relevant to service planning and discussions about the value of surgical care for degenerative cervical myelopathy. It may help clinicians, commissioners and researchers understand costs alongside patient outcomes.
What this means in context
Cost-effectiveness evidence informs healthcare planning but does not decide treatment for an individual patient. Treatment decisions depend on symptoms, imaging, neurological function, progression, general health, risks and specialist assessment.
View published abstract
The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.
Purpose: Degenerative cervical myelopathy (DCM) is the commonest cause of adult spinal cord dysfunction worldwide, for which surgery is the mainstay of treatment. At present, there is limited literature on the costs associated with the surgical management of DCM, and none from the United Kingdom (UK). This study aimed to evaluate the cost-effectiveness of DCM surgery within the National Health Service, UK.
Materials and methods: Incidence of DCM was identified from the Hospital Episode Statistics (HES) database for a single year using five ICD-10 diagnostic codes to represent DCM. Health Resource Group (HRG) data was used to estimate the mean incremental surgery (treatment) costs compared to non-surgical care, and the incremental effect (quality adjusted life year (QALY) gain) was based on data from a previous study. A cost per QALY value of <£30,000/QALY (GBP) was considered acceptable and cost-effective, as per the National Institute for Health and Clinical Excellence (NICE) guidance. A sensitivity analysis was undertaken (±5%, ±10% and ±20%) to account for variance in both the cost of admission and QALY gain.
Results: The total number of admissions for DCM in 2018 was 4,218. Mean age was 62 years, with 54% of admissions being of working age (18-65 years). The overall estimated cost of admissions for DCM was £38,871,534 for the year. The mean incremental (per patient) cost of surgical management of DCM was estimated to be £9,216 (ranged £2,358 to £9,304), with a QALY gain of 0.64, giving an estimated cost per QALY value of £14,399/QALY. Varying the QALY gain by ±20%, resulted in cost/QALY figures between £12,000 (+20%) and £17,999 (-20%).
Conclusions: Surgery is estimated to be a cost-effective treatment of DCM amongst the UK population.
Keywords: cervical; cost; degeneration; myelopathy; surgery.
View the original publication on PubMed
About Mr Gordan Grahovac
Mr Gordan Grahovac is a Consultant Neurosurgeon and Complex Spinal Surgeon with expertise in managing complex spinal and neurosurgical conditions.
His work includes the assessment and treatment of patients with degenerative spinal conditions, spinal cord compression, spinal tumours, complex spinal pathology and conditions requiring specialist neurosurgical input.
His approach focuses on careful diagnosis, appropriate treatment planning and helping patients understand their options clearly.
Important note
This page is for educational purposes only and should not be taken as individual medical advice.
If you or someone you know has symptoms such as worsening headache, confusion, drowsiness, weakness, changes in speech, seizures, balance problems or symptoms following a head injury, seek urgent medical advice.
