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Object: Patients suffering from cervical radiculopathy in whom a course of nonoperative treatment has failed are often candidates for a single-level anterior cervical discectomy and fusion (ACDF) or posterior cervical foraminotomy (PCF). The objective of this analysis was to identify any significant cost differences between these surgical methods by comparing direct costs to the hospital. Furthermore, patient-specific characteristics were also considered for their effect on component costs., Methods: After obtaining approval from the medical center institutional review board, the authors conducted a retrospective cross-sectional comparative cohort study, with a sample of 101 patients diagnosed with cervical radiculopathy and who underwent an initial single-level ACDF or minimally invasive PCF during a 3-year period. Using these data, bivariate analyses were conducted to determine significant differences in direct total procedure and component costs between surgical techniques. Factorial ANOVAs were also conducted to determine any relationship between patient sex and smoking status to the component costs per surgery., Results: The mean total direct cost for an ACDF was $8192, and the mean total direct cost for a PCF was $4320. There were significant differences in the cost components for direct costs and operating room supply costs. It was found that there was no statistically significant difference in component costs with regard to patient sex or smoking status., Conclusions: In the management of single-level cervical radiculopathy, the present analysis has revealed that the average cost of an ACDF is 89% more than a PCF. This increased cost is largely due to the cost of surgical implants. These results do not appear to be dependent on patient sex or smoking status. When combined with results from previous studies highlighting the comparable patient outcomes for either procedure, the authors' findings suggest that from a health care economics standpoint, physicians should consider a minimally invasive PCF in the treatment of cervical radiculopathy.

Long-term maintenance of behavioral change to reduce health risk factors is essential to producing a positive effect on medical outcomes. This study examines whether an ongoing, long-term relationship can be used to help patients diagnosed with coronary artery disease adhere to a risk-reducing behavioral intervention and maintain healthy behavioral changes. One hundred and sixty patients with diagnosed coronary artery disease will be randomized to a standard behavioral treatment group or to a standard behavioral treatment group including a couples intervention and followed for 18 months. The treatment in both groups follows tenets of cognitive behavioral and Self-Determination Theories as well as the Transtheoretical Model of Behavior Change. In addition, the couples intervention is designed to (1) change the patient's environment to facilitate cardiac risk-reducing behavioral changes, (2) optimize social reinforcement and motivation for behavior change, and (3) decrease relationship stress. Behavioral outcomes assessed include adherence to an exercise regimen, adherence to dietary recommendations and adherence to lipid-lowering medication. Lipid values, psychological variables and relationship variables are assessed throughout the study and at follow-up. While we expect both groups of cardiac patients to successfully adapt new health behaviors, we expect the couples intervention to be superior in helping maintain long-term health behaviors.