ASC spine surgery: 10 observations for 2022

Spine surgery is becoming more prominent at ASCs as minimally invasive technologies advance and payers are more willing to reimburse for spine surgery in the outpatient setting.

Ten observations on outpatient spine surgery this year:

1. More than 190 ASCs in the U.S. offer minimally invasive spine surgery, which has seen a significant increase in the past decade.

2. Less than 10 years ago, virtually all spine surgeries were performed on an inpatient basis, according to Outpatient Surgery.. Recent advances in surgical techniques, anesthesia and postoperative rehab have resulted in shorter procedures with less blood loss and fewer complications, allowing surgeons to send patients home safely within 24 hours of surgery and at a lower cost.

3. Outpatient spine surgery is projected to become the new normal, which medtech companies will have to adapt to, offering more services to help surgeons transition their practices to the ambulatory environment. Remote patient monitoring tools as well as augmented reality and virtual reality technologies to train surgeons and staff are expected to become more prominent.

4. ASCs should not expect insurers to pay them more solely because they are saving money by moving spine procedures from hospitals to surgery centers. Administrators will be required to back up their requests with data to optimize the reimbursement they can receive for spine procedures. Having robust data and investing in technology to collect that data is also becoming increasingly important to running efficient operations.

5. Advancements in treatment protocols and care mean surgeons can do more in less time with less trauma to the body. Endoscopic spine surgery represents a significant opportunity to drive more spine procedures to the outpatient setting, according to Vik Mehta, MD, of Hoag Hospital in Newport Beach, Calif.

6. The spine field is trending away from fusions in the neck toward disc arthroplasty, or artificial disc replacement. Recent studies have demonstrated the ability of motion-preserving technologies to provide patients with a better range of motion and a higher quality of life compared with fusion.

7. Spine procedures commonly performed on an outpatient basis today include anterior cervical discectomy and fusion, artificial disc replacement, transforaminal lumbar interbody fusion, lumbar discectomy and laminectomy.

8. Since the onset of the COVID-19 pandemic, many surgeons were forced to take cases to surgery centers when restrictions on nonurgent surgeries were implemented at hospitals. Many surgeons' eyes were opened to the increased efficiency of ASC operating rooms, which often run smoother than hospital ORs, where complexities, turnover times and delays are common.

9. There is also a financial incentive for spine surgeons taking cases to ASCs, where operating rooms are more efficient and can do more cases per day, the cost of surgery is lower and surgeons can share in the ownership of the center.

10. Spine practices will continue to attract investment from private equity groups and management services organizations. In recent months, DISC Sports & Spine Center in Newport Beach, Calif., affiliated with Trias Global, and Chicago Pacific Founders and Atlanta-based Resurgens Orthopaedics —  the largest orthopedic group in Georgia — partnered with New York City-based private equity firm Welsh, Carson, Anderson & Stowe to build an orthopedic platform.

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