May 22, 2015

I’ve been hearing more frequently from patients who want to spend less time in the hospital after surgery.  The sentiment makes sense, given the trend towards outpatient surgery in a variety of specialties.

In truth, surgeons have been performing certain spine procedures on an outpatient basis for two decades. And thanks to the advances in technology and anesthesia, the types of spine surgeries that can be performed in ambulatory surgery centers (ASC) is growing. According to the healthcare consulting firm NeuStrategy, outpatient spine surgeries were expected to grow from 27,559 to more than 284,000 this year.

At present, anywhere from 30 percent to 50 percent of my surgeries can be performed at an ASC. For the right patient, an ASC setting can offer a number of benefits. Since many of the surgeries performed at these facilities are minimally invasive, patients are often able to go home the same day of their surgery.

The ASC environment also offers a lower risk of infection because fewer patients are staying overnight and unlike hospitals, the centers don’t treat any medical conditions, which lessens the chance of picking up bacteria from another patient or medical providers in the hospital setting. Patients also tend to like the more personal, specialized approach provided at an ASC.

Since the cost to run an ASC is less, the overall cost of the operation is lower than the full service hospital and therefore lower cost to the patient in the long run.

Of course, an ASC isn’t option for everyone. Patients with serious illnesses or poorly-controlled chronic conditions may not be good candidates for outpatient procedures. It’s also important to note that some complex spine surgeries remain restricted to the hospital setting.

  • In my practice, we feel comfortable performing  the following procedures at an ASC: Laminectomy, discectomy and fusion (1 level)
  • Anterior cervical (neck) discectomy and fusion (1-2 levels)
  • Anterior cervical Disc replacement
  • Posterior cervical discectomy and/or for aminotomies
  • Spinal cord stimulation placement.

With ongoing progress towards less invasive surgery, we will see more operations being done in ASC settings in the future.