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For close to the last 10 years, there has been a move to perform spine surgeries away from hospitals and into outpatient ambulatory surgery centers. From a clinical standpoint, the advancements in technology have played the largest role in this transition. Minimally invasive surgical instrumentation, such as operating microscopes and enhanced lighting, with changes in pre and post operative drug protocols, have made pain management throughout the process much easier. Surgical techniques have also changed, giving surgeons many different options for less risky, minimally invasive surgery. Overall, these changes have allowed patients to be ambulatory and moving around much quicker after surgery. As a result, the ambulatory setting is likely to continue to grow for spine procedures over the next 10 years.

What Are the Most Common Conditions Requiring Outpatient Spine Surgery? There are several common conditions that Dr. Dolphin commonly sees in patients that are ideal for outpatient spine surgery. Among the most common are herniated discs, spinal stenosis and cervical degeneration. One of the surgeon’s most important roles is to educate you on the different treatment options for your condition and assist you in the decision making process. Part of this process is providing you with options but also making sure that the expectations of what are technically possible, as well as discussing the risk and potential benefits of these options, is communicated.

How does outpatient spine surgery differ from inpatient spine surgery? Minimally invasive outpatient spine surgery, is a surgical technique that allows the spine condition to be surgically corrected with small surgical incisions. When compared to a more traditional inpatient surgery, minimally invasive surgical procedures are much less damaging to the soft tissue and muscles that surround the spine. This typically results in a much quicker recovery. Other common advantages of this approach include less blood loss and a lower rate of postoperative infection when compared to traditional inpatient spine surgery. Patients are typically home within hours of surgery for most cases. Some of the most common outpatient spine surgeries that Dr. Dolphin performs are:

• Lumbar and Cervical Microdiscectomy
• Laminectomy
• ACDF (Anterior Cervical Discectomy and Fusion)-23 hour return home

Lumbar discectomy is the most common spinal surgical procedure performed and can safely be done on an outpatient basis. A recent study published Spine (01 February 2013 – Volume 38 – Issue 3 – p 264–271), looked at patients who underwent lumbar discectomy between the years 2005 and 2010 (a total of 4310 inpatient and 1652 outpatient). This study showed that patients undergoing outpatient lumbar discectomy had lower overall short term complication rates then those who had the same surgery performed on an inpatient basis. In addition to lumbar microdiscetomy, Dr. Dolphin also performs cervical discectomies to alleviate the pain associated with herniated/ruptured discs in the neck or cervical spine.

As the only spine surgeon in the Quad Cities to perform spine surgeries in an outpatient ambulatory surgery center, Dr. Michael Dolphin, of Orthopaedic Specialists, has been leading the charge to grow this option for patients locally. “As technology continues to improve and the large baby boomer population continues to grow older, it is my hope that Medicare, like most other commercial insurance carriers have, will begin to see both the financial and quality benefit of allowing these sort of procedures to be performed on an outpatient basis,” says Dr. Dolphin.  “The data is there to support safety, quality, outstanding results and cost savings.”

For more information on other back and neck conditions that Dr. Dolphin performs please visit www.osquadcities.com. Like us on Facebook at facebook.com/osquadcities. Dr. Dolphin’s next blog in this series will discuss the topic of “Laser Spine Surgery: Is it Really What it Says it Is?”