The volume of outpatient spine surgeries has been on the rise in the U.S. the last several years, with more than 200 ASCs now performing procedures.
ASC-based spine surgeries still face obstacles, but when they are performed, experts say they can offer patients better outcomes and quicker recovery times.
They are also more cost-effective than procedures performed in the hospital setting on average.
Hoag Orthopedic Institute Surgery Center Beverly Hills (Calif.) is making strides in the adoption of more complex spine procedures, and its recent Globus spine robot addition is part of that effort.
Alexandre Rasouli, MD, an orthopedic surgeon at Irvine, Calif.-based Hoag's Beverly Hills location and founder of Rasouli Spine, shared with Becker's key changes that are needed before more spine surgeries can take place in the ASC setting.
Note: This response has been lightly edited for length and clarity.
Dr. Alexandre Rasouli: It would be ideal to have more cases done in the ASC setting, but whether I see that happening or not relies on some obstacles.
The first one is the patient perception that spine surgery has to be done in the hospital. Spine surgery, if surgical candidates are properly chosen, are very amenable to outpatient settings.
Second is a professional perception. Surgeons are often cautious under the notion or guise of safety, but in properly chosen cases, surgery centers can be safer than hospital settings.
The third obstacle is regulatory. Insurance companies are well meaning and want to add value to healthcare delivery, but they will probably have to analyze many more years of data before allowing us to do various spine surgeries in the outpatient setting.
The final [obstacle is] surgeon skill set, because the skill set needed for performing surgery in the ASC is very different than one required in the hospital. The surgeon has to be skilled, efficient, blood loss has to be minimal and surgeries have to be well choreographed.
If all of those elements are addressed, then we're going to start to see a large transition to the ASC setting and hopefully with better pay back for the patient, as well as better outcomes for surgeons, payers and delivering quality care.