Patients must have
few or no co-mor-
bidities and be moti-
vated before under-
going any type of
outpatient spinal sur-
gery. A 90-year-old
who is on blood
thinners is a poor
choice, but a 38-year-
old healthy woman
who has attended all
of her previous phys-
ical therapy sessions is likely to succeed. Additionally, while a sur-
geon may think the patient is an ideal candidate for outpatient spinal
surgery, the decision should ultimately come down to whether the
patient feels it is right.
You also need to ensure that you have the right surgeons performing
these procedures at your facility. Before clearing surgeons for outpa-
tient spine, make sure they can prove that they have a clear history
with discharging their cases within 23 hours.
Be aware that not all spine cases are created equal. Just because a
surgeon routinely discharges laminectomy patients the same day
doesn't mean you should clear him for more complex procedures like
lumbar spinal fusions. Also note that most surgeon fellowship training
programs don't offer an "outpatient" program, so younger surgeons will
likely have a steeper learning curve than veteran doctors.
Finally, the individual surgeon's technique also plays a role in
avoiding complications. For example, in lumbar spinal fusions —
the next big thing in outpatient spine — there are several tech-
1 4 8
O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 5
z SAFER SPINE SSIs, dural tears and bleeding are some
of the common complications of complex spine cases.