Our Summary

This research paper looks at the safety of performing a specific type of spine surgery (anterior cervical discectomy and fusion, or ACDF) in outpatient surgery centers (ASCs) rather than in hospitals. The researchers studied 2000 cases where this surgery was performed in an ASC between 2006 and 2018.

They found that only a very small number of patients (0.5%) needed to be transferred to a hospital within the 4 hours after their surgery, and reasons for this included complications like bleeding or pain control problems. Only 0.3% of patients had to have another operation within 30 days, and less than 2% were readmitted within 30 days for any reason.

The study concludes that this type of surgery can be safely performed in an outpatient setting, as long as certain protocols are followed. This could help to reduce healthcare costs by avoiding unnecessary hospital stays.

FAQs

  1. What is the safety of performing anterior cervical discectomy and fusion in outpatient surgery centers versus hospitals?
  2. What were the main reasons for patients needing to be transferred to a hospital after undergoing surgery in an ASC?
  3. How can performing this type of surgery in an outpatient setting help to reduce healthcare costs?

Doctor’s Tip

One helpful tip a doctor might tell a patient about discectomy is to follow post-operative care instructions carefully. This may include restrictions on physical activity, proper wound care, and taking medications as prescribed. It is important to attend all follow-up appointments to monitor progress and ensure proper healing. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can aid in the recovery process.

Suitable For

Patients who are typically recommended for discectomy are those who have tried conservative treatments such as physical therapy, medications, and injections, but continue to experience severe pain and disability due to a herniated disc or other spinal condition. Candidates for discectomy may have symptoms such as radiating pain, numbness, weakness, or loss of bladder or bowel control. Additionally, patients who have not responded to non-surgical treatments for at least 6 weeks may be considered for discectomy. It is important for patients to undergo a thorough evaluation by a spine specialist to determine if they are suitable candidates for this type of surgery.

Timeline

Before the discectomy:

  1. The patient experiences symptoms of a herniated disc, such as back pain, leg pain, or weakness.
  2. The patient undergoes imaging tests like an MRI or CT scan to diagnose the herniated disc.
  3. The patient may try conservative treatments like physical therapy or medication before considering surgery.
  4. The patient consults with a spine surgeon to discuss the options for treatment, including the possibility of a discectomy.

After the discectomy:

  1. The patient undergoes the discectomy surgery in an outpatient surgery center.
  2. After the surgery, the patient is monitored for a few hours in the recovery room.
  3. The patient is discharged home the same day with instructions for post-operative care.
  4. The patient may experience some pain and discomfort in the days following the surgery, but this typically improves over time.
  5. The patient follows up with the surgeon for post-operative check-ups to ensure proper healing and recovery.
  6. The patient gradually resumes normal activities and physical therapy to regain strength and mobility in the affected area.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy surgery?
  2. How long is the recovery period after a discectomy surgery?
  3. What type of anesthesia will be used during the surgery?
  4. What are the success rates for this type of surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. What restrictions or limitations will I have after the surgery?
  7. How long will I need to take pain medications after the surgery?
  8. What signs or symptoms should I watch for that may indicate a complication following the surgery?
  9. Will I need any follow-up appointments or imaging studies after the surgery?
  10. What is the experience and success rate of the surgeon performing the discectomy surgery?

Reference

Authors: McGirt MJ, Rossi V, Peters D, Dyer H, Coric D, Asher AL, Pfortmiller D, Adamson T. Journal: Neurosurgery. 2020 Mar 1;86(3):E310-E315. doi: 10.1093/neuros/nyz514. PMID: 31819994