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Neurosurgery. 2018 Aug 1;83(2):159-165. doi: 10.1093/neuros/nyy057.

Spine Surgery in the Ambulatory Surgery Center Setting: Value-Based Advancement or Safety Liability?

Author information

1
Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
2
Department of Orthopedics Surgery, Rush University Medical Center, Chicago, Illinois.
3
Depart-ment of Neurological Surgery, Carolina Neurosurgery and Spine Associates, Charlotte, North Carolina.

Abstract

Here, we systematically review clinical studies that report morbidity and outcomes data for cervical and lumbar surgeries performed in ambulatory surgery centers (ASCs). We focus on anterior cervical discectomy and fusion (ACDF), posterior cervical foraminotomy, cervical arthroplasty, lumbar microdiscectomy, lumbar laminectomy, and minimally invasive transforaminal interbody fusion (TLIF) and lateral lumbar interbody fusion, as these are prevalent and surgical spine procedures that are becoming more commonly performed in ASC settings.A systematic search of PubMed was conducted, using combinations of the following phrases: "outpatient," "ambulatory," or "ASC" with "anterior cervical discectomy fusion," "ACDF," "cervical arthroplasty," "lumbar," "microdiscectomy," "laminectomy," "transforaminal lumbar interbody fusion," "spine surgery," or "TLIF."In reviewing the available literature to date, there is ample level 3 (retrospective comparisons) and level 4 (case series) evidence to support both the safety and effectiveness of outpatient cervical and lumbar surgery. While no level 1 or 2 (randomized clinical trials) evidence currently exists, the plethora of real-world clinical data creates a formidable argument for serious investments in ASCs for multiple spine procedures.

PMID:
29538716
DOI:
10.1093/neuros/nyy057
[Indexed for MEDLINE]

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