Gowriharan Thaiyananthan, MD, a spine surgeon and founder of BASIC Spine in Newport Beach, Calif., discusses how data gathering in healthcare is driving spine procedures outpatient.
Q: There are still people who are skeptical of doing any spine procedures in the outpatient setting. Will anything change their minds?
Dr. Gowriharan Thaiyananthan: The key with information technology is to collect data showing we are able to do spine surgery better in the outpatient setting with lower cost and higher patient satisfaction. Medicine is data-driven today, and there is traditional resistance to paradigm shifts for treatment. But when we do outpatient surgery, we can show patients have a faster recovery.
Q: What are the most important innovations in outpatient spine today?
GT: In order of importance, really the development of anesthesia techniques that allow us to convert traditionally inpatient to outpatient procedures. There has been advancement in minimally invasive techniques that allow us to do procedures faster with less complications and blood loss. Patients don't have to spend three or four days in the hospital after surgery now because we're managing their pain better.
Q: What new technologies or devices could make an impact on outpatient spine in the future?
GT: There are definitely developments on the implant side. Two main factors in technology development are less invasive procedures and shorter surgical time. One example is interspinous clamps. Another is XLIF because you can do lumbar fusions as an outpatient procedure. The changes in technology allow for more strategic surgeries with hardware.
Q How can spine surgeons optimize their outpatient procedures? What do they need to know about transitioning cases from inpatient to outpatient?
GT: We realized it was a team approach at our practice, not the skill set of one surgeon in particular. You need a good anesthesiologist and team around the surgeon to make sure the procedure is efficient. You want to make sure the anesthesiologist can wake up the patient safely and screens the patient for comorbidities so you know they're a good candidate for the outpatient center.
Q: Will more spine surgeons be performing cases in outpatient ambulatory surgery centers five years from now?
GT: Most outpatient procedures are done at an ASC and with the cost of implants declining and as technology improves we'll see more procedures done in the ASC. Additionally, patients want minimally invasive procedures. They don't want to spend a week in the hospital. They want to walk out of the center and recover more quickly.