Although spine surgery is trending toward the ASC, there still are some obstacles ahead, Mark Testaiuti, MD, said.
Dr. Testaiuti, of Coastal Spine in Mount Laurel, N.J., shared his outlook with Becker's.
Note: This response was lightly edited for clarity.
Question: What will the outpatient spine surgery landscape look like in five years?
Dr. Mark Testaiuti: Spine surgery has evolved considerably over the last 10 to 15 years with advances in minimally invasive surgery, total disc replacement options and even hybrid fusion options improving patient outcomes and minimizing the impact of the surgeries long-term for the patient.
The five year horizon for spine surgery is for the trend towards outpatient surgery to continue as outcomes and efficacy are proven. I see continued improvements in minimally invasive lumbar spinal fusion surgery and arthroplasty will continue evolving. At some point we would expect Medicare to approve the same inpatient codes for instrumentation in the ASC. Unfortunately antiquated guidelines seem to be the main stumbling block for otherwise healthy Medicare Recipients to receive the benefit of outpatient spinal fusion surgery in the ASC.
From a cost containment standpoint it has already been shown that outpatient spinal fusions cost on average 50% less to the payer compared to inpatient cases. Although the hospital lobbyist might not be happy about that, this is the way spine surgery has been going and will continue.
It goes without saying that outpatient spine surgery should not be done by a novice, or someone not trained in performing safe outpatient spinal surgeries in the hospital first. We must continue to police ourselves in this regard and not put profit before patient safety in the ASC.