Several studies published in the last decade examine the safety and efficacy of spine surgery in the outpatient ASC. Pugley et al. used the American College of Surgeons National Quality Improvement Program database to compare the overall complication rate for inpatient and outpatient lumbar discectomies, showing inpatient procedures have a 6.5 percent complication rate compared to 3.5 percent for outpatient surgeries. The article was originally published in a 2013 edition of Spine.
In its recent coverage of outpatient surgery centers, USA Today and Kaiser Health News did not mention this study and instead highlighted stories from individuals who experienced complications at outpatient surgery centers. In response, several organizations including the Ambulatory Surgery Center Association and the Society for Ambulatory Anesthesia have responded with data-driven evidence to support outpatient surgery for the appropriately selected patients in centers that comply with regulatory standards.
Spine surgery is now different; Khanna et al. compares the complication rates for outpatient and inpatient anterior cervical discectomy and fusion, reporting a 2.5 percent complication rate for inpatient ACDF and 1.2 percent complication rate for outpatient ACDF. Readmission rates were also higher in the inpatient group.
There are several reasons why complication rates are lower in the outpatient setting, including selection bias; patients healthy enough to undergo outpatient surgery don't spread infectious diseases and don't have comorbidities that put them at increased risk.