A new research study titled “A Comparison of Multilevel Anterior Cervical Discectomy and Fusion Performed in an Inpatient versus Outpatient Setting” has proven that removal of multiple herniated or degenerated discs in the neck can be performed in an outpatient setting through anterior cervical discectomy and fusion (ACDF) in select patients.
The study was conducted at the Hospital for Special Surgery (HSS) in New York City.
“An emphasis on reducing healthcare costs has led to numerous surgeries in a wide range of specialties being performed on an outpatient basis,” commented Sheeraz Qureshi, the Patty and Jay Baker Chair in Minimally Invasive Spine Surgery. “Single-level ACDF, in which one disc is removed, is one of the most common spine surgeries performed in an outpatient setting.”
According to experts, ACDF can be performed when the pain is ongoing and when the nonsurgical treatment does not provide relief. The procedure thus helps in removing a damaged disc or discs, in addition to other bone spurs which are developed. A bone graft is inserted in the open space after the disc has been removed. This graft helps in creating a bridge between the two vertebrae in order to create a spinal fusion.
Experts suggest, despite the success of single-level ACDF in an out-patient setting, there are still concerns over increased postoperative complications, along with respiratory problems. These have in return hampered the performance of multi-level ACDF in an outpatient setting.
The study included 103 patients, out of which 57 had surgery as outpatients, whereas 46 had a hospital stay. The inpatients belonged to a median age of 57 versus 52 years old.
“In our study, the surgical setting did not impact patient-reported outcomes. The results suggest that multi-level ACDF can be performed safely in the outpatient setting without an increased risk of complications in appropriately selected patients,” Dr. Qureshi commented. “Specifically, the patient’s age, additional health conditions, and the number of levels being fused should be taken into consideration when deciding whether to perform multi-level ACDF in an outpatient setting.”