Research published in the International Journal of Spine Surgery examined the safety and efficiency of cervical disc arthroplasty in ASCs compared to hospital settings.
Researchers conducted a retroactive collection and analysis of data from cervical disc arthroplasty patients treated in ASCs compared to a control group treated on both an outpatient and inpatient basis at hospitals. Blood loss, adverse events, subsequent surgeries and return to work were compared between ASCs and hospitals. The sample included 145 ASC patients, 348 hospital outpatients and 65 inpatients.
Here are the key research insights to know:
1. Surgery times were shorter in ASCs than in hospital outpatient or inpatient level-one departments — 63.6, 86.5 and 166.7 minutes for ASCs, outpatient and inpatient surgery at hospitals, respectively.
2. Estimated blood loss was lower in ASCs than hospitals for one and two level procedures — 18.5, 43.7 and 65.7 milliliters for ASCs, outpatient and inpatient surgery at hospitals, respectively.
3. In the 90 days following surgery, one device or surgery-related adverse event was reported in the ASC group, compared to 10 for the hospital cohort. The adverse event reported in the ASC group was a wound dehiscence, which was treated in an emergency room, and did not require surgery. The 10 adverse events reported in the hospital cohort included neck and arm pain, dysphagia, hematoma and an incorrectly placed device. Four hospital patients required a secondary surgery, two required hematoma drainage, one needed a laminectomy for radiculopathy and one patient required a disc replacement to the correct position.
4. More patients who underwent cervical disc arthroplasty in ASCs did not returned to work during the 90-day postoperative period than patients who underwent surgery in the hospital. The average number of days patients spent off work was 28.6, 23.4 and 41.6 for ASCs, outpatient and inpatient surgery at hospitals, respectively.
5. "Both one- and two-level CDA may be performed safely in an ASC. Surgeries in ASCs are of shorter duration and performed with less blood loss without increased AEs," the researchers concluded.
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