Outpatient ACDF results showed few complications, readmissions

SAN DIEGO — Anterior cervical discectomy and fusion performed on an outpatient basis is safe and has some added benefits, according to a presentation by Tim E. Adamson, MD, at the Congress of Neurological Surgeons Annual Meeting, here.

“Technologic[al] advances both surgically and [in] anesthetic[s] have allowed us to transition anterior cervical decompression and fusion (ACDF) to an outpatient basis safely, effectively and with significant cost savings,” Adamson said.

For the outpatient ACDF results prior to 10 years that Adamson discussed, “The 30-day hospital readmission rate was about 2%,” he said. The readmission rate from 30 days to 90 days was about 1%.

“No patient suffered a catastrophic complication from being discharged to home vs. being in the hospital,” Adamson said.

When Adamson and colleagues compared inpatient and outpatient ACDF, they found nearly identical results in terms of outcome scales. They also found a $7,000 to $8,000 cost savings per case for outpatient ACDF surgery.

“We have now done almost 1,600 outpatient ACDFs,” Adamson said. This included 963 one-level and 592 two-level cases, some three-level ACDFs, five corpectomies done with a 23-hour stay, and 53 total disc arthroplasty surgeries.

The nearly 600 added cases Adamson and colleagues did to attain 10 years of experience with these procedures resulted in one additional hospital transfer. This was due to respiratory issues of the patient, Adamson noted.

“The current transfer rate is now down to 0.5%,” he said. – by Susan M. Rapp

Reference:

Adamson TE. Anterior cervical surgery: Outpatient ACDF — Safety and outcomes. Presented at: Congress of Neurological Surgeons Annual Meeting; Sept. 24-28, 2016; San Diego.

Disclosure: Adamson reports he is a consultant to Spinewave.