Outpatient spine surgery will keep growing as techniques become more minimally invasive, and centers can take more complex cases.
Here's what two spine surgeons predict.
Brandon Hirsch, MD. DISC Sports & Spine Center (Newport Beach, Calif.): I think the acuity of cases done in the free-standing outpatient center is likely to continue to increase. What we're doing at our centers today are cases that many surgeons historically would perform only in hospital settings. We do anterior lumbar exposures safely and routinely because we have excellent vascular access and tried and true perioperative protocols. Surgeons at our centers have the equipment, the staff expertise and the setup to handle higher acuity spine cases. I have to imagine that other groups who are serious about outpatient spine surgery are going to make similar plans.
Over the past two decades, it has also become more and more challenging for spine surgeons to work in the hospital setting, particularly if they're not an employee of the hospital. It is also difficult for a traditional hospital to give a high-quality patient experience around spine surgery because the facility has to be able to provide care for many different health conditions at varying levels of acuity. Some inpatient facilities do this well because spine surgery is the main focus of the hospital. Unfortunately, nationwide this is more the exception than the rule. A highly specialized center that routinely does outpatient spine surgery every day is going to provide a better experience for both patients and their surgeons.
Ezriel Kornel, MD. Somers Orthopaedic Surgery and Sports Medicine Group (Carmel, N.Y.): Outpatient spine surgery will continue to grow, but it's essential to ensure patients are medically stable and suitable for this setting. Factors like pre-existing conditions or pulmonary issues may require closer monitoring, which limits the feasibility of outpatient procedures for some patients.
Pain management is another consideration. Certain patients may experience more post-operative pain, requiring overnight observation for pain control. While minimally invasive techniques reduce trauma and stress on the body, outpatient procedures won't be possible for every case or every patient. Some surgeries will always require a hospital setting for optimal care.