Hospital vs. ASC spinal fusions: 5 findings on ACDF

A new study published in the Journal of Neurosurgery: Spine examines outcomes for anterior cervical discectomy and fusion patients in the inpatient and outpatient setting.


The study authors examined data from 272 consecutive patients who underwent spinal fusion, including 172 patients who had the procedure at the hospital and 100 who had surgery at an ASC. They found:

1. Patients directed to the hospital setting were more likely to undergo multilevel procedures and have longer length of stay than at the ASC. In the hospital, 48.3 percent of the patients went home within 24 hours of surgery and another 43 percent returned home within 48 hours.

2. The patients who underwent surgery at the ASC were more likely to have workers compensation insurance than patients who underwent hospital-based procedures.

3. Pain scores were similar between both groups of patients.

4. The patients who underwent surgery at the hospital were more likely to consume narcotics.

5. One patient in the ASC reported a pretracheal hematoma, which was immediately evacuated. In the hospital, eight patients had dysphagia, compared to three in the ASC setting. All of the dysphasia patients reported the issue was resolved within six months.

"Based on the results of this single surgeon's experience, one- to two-level ACDFs may be performed successfully in the outpatient setting in appropriately selected patient populations," concluded the study authors.

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