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Future endeavors in ambulatory spine surgery
Avani S Vaishnav1, Steven J McAnany1,2
1Hospital for Special Surgery, New York, NY, USA.
Journal of Spine Surgery (Hong Kong)
|October 29, 2019
Summary
Ambulatory surgery centers (ASCs) offer spine surgery cost reduction but face limited adoption due to safety concerns and lack of guidelines. Future growth requires evidence-based protocols and improved patient selection for wider accessibility.
Area of Science:
- Neurosurgery
- Healthcare Management
- Health Economics
Background:
- Spinal disorders impose significant societal and financial burdens, making spine surgery a key target for healthcare cost reduction.
- Ambulatory surgery centers (ASCs) are increasingly explored for cost-savings across surgical specialties, including spine surgery.
- Current ASC spine surgery utilization in the US is limited, primarily to specific procedures like lumbar microdiscectomy and anterior cervical discectomy and fusion (ACDF) at high-volume centers.
Purpose of the Study:
- To explore the potential of ambulatory surgery centers (ASCs) for cost reduction in spine surgery.
- To identify barriers to wider adoption of ASCs for spine surgery and propose solutions.
- To discuss the future growth and innovation potential of ambulatory spine surgery.
Main Methods:
- Review of current literature and practices regarding ASC utilization in spine surgery.
- Analysis of factors limiting wider adoption, including safety concerns, guidelines, and patient accessibility.
- Discussion of strategies for optimizing patient selection, care protocols, and post-operative monitoring.
Main Results:
- Limited adoption of ASCs for spine surgery is attributed to risks of complications, lack of guidelines, and accessibility issues.
- Successful expansion of ambulatory spine surgery hinges on developing evidence-based guidelines, risk-stratification tools, and optimized care protocols.
- Electronic health tools and process improvements are crucial for enhancing post-operative monitoring and peri-operative management.
Conclusions:
- Ambulatory spine surgery presents a significant opportunity for cost reduction and value creation.
- Addressing safety concerns and establishing clear guidelines are essential for increasing ASC utilization in spine surgery.
- Optimizing upstream and downstream organization, alongside technological integration, will drive the success of ambulatory spine surgery.
