2-level spinal fusions safe in outpatient settings, new study finds: 5 things to know

A new study published in Spine examines whether outpatient spinal fusion cases are safe.


The study authors gathered data on 22,006 spinal fusion cases, 4,759 of which were outpatient, from the National Surgical Quality Improvement database. The one- and two-level procedures were performed from 2011 to 2014. The researchers found:

1. There were 6,890 two-level cases all together and 20.7 percent were performed in the outpatient setting.

2. The complication rate for outpatient two-level spinal fusions was 1.47 percent, compared to 3.94 percent for inpatients.

3. There was a lower rate of postoperative complications among outpatient procedures, according to a propensity-adjusted multivariate regression model.

4. The independent risk factors for post discharge complications among the spinal fusion patients were:

• Greater comorbidity burden
• Higher ASA class
• Chronic steroid use
• Hypertension
• Male sex

5. Study authors concluded, "After adjusting for selection bias and patient risk factors, outpatient two-level ACDF was not associated with increased postoperative morbidity relative to inpatients, and may be considered in appropriately indicated patients."

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