Eight spine surgeons discuss patient selection for spine surgery in outpatient settings.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
Question: What are the key elements of patient selection for outpatient spine surgery?
Noam Stadlan, MD. Neurosurgeon at NorthShore University HealthSystem’s Neurological Institute (Skokie/Evanston, Ill.): The two factors that contribute to successful outpatient spine surgery are the surgery and the patient. Microdiscectomies and small minimally invasive or mini-open lumbar surgeries are ideal cases, as are uncomplicated one- and two-level anterior cervical discectomies with placement of artificial discs or fusions. There is robust data that supports performing these cases on an outpatient basis, as long as the patient does not have significant medical issues.
Patients with significant medical problems such as cardiac or respiratory problems, poorly controlled or insulin-dependent diabetics, the elderly and others are best served by having surgery at a facility where there is an inpatient option. Patient anatomic issues such as obesity should also be considered.
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