DISC Study Highlights Major Shift in Spine Care as High-Acuity Fusions Move Out of Hospitals and into ASCs

An operating room at DISC Surgery Center at Marina del Rey. | Photo provided by TriasMD

A new retrospective study from DISC Surgery Centers adds to the growing evidence that even the most complex spine procedures can be safely shifted into the ambulatory setting – while delivering meaningful cost savings for payers and better experiences for patients at the same time.

The 203-patient analysis, led by orthopedic spine surgeon Dr. Steven Girdler, examined anterior-posterior lumbar interbody fusions (ALIF + PSF), commonly known as 360° fusions, performed at a single outpatient center between 2018 and 2024. All patients were discharged within 23 hours, with no hospital transfers, no postoperative blood transfusions and no readmissions during the immediate perioperative period, according to the study abstract.

“These are highly complex procedures that once required three or four days in the hospital,” DISC’s Dr. Girdler said in a study announcement. “To safely complete a 360° fusion as a single, minimally invasive episode of care and discharge patients within 23 hours is a major step forward for both patient outcomes and the health care system.”

The analysis also highlights a serious financial upside.

Prior research has shown that shifting lumbar fusion cases to the outpatient setting can reduce total episode-of-care costs by 50% to 70% compared with inpatient procedures. With more than 455,000 inpatient spinal-fusion admissions recorded nationally in 2018, even partial migration of appropriate cases could save health systems an estimated $800 million to $1.2 billion annually.

DISC parent company TriasMD believes those outcomes and potential cost savings reflect a deliberate model designed around minimally invasive technique, customized perioperative protocols and purpose-built facilities.

“When you bring together top-tier surgeons, state-of-the-art technology, and a proven clinical model – and deliver it all within a concierge-level patient experience – even the highest-acuity procedures can be performed successfully in an ASC setting,” James H. Becker, CEO of TriasMD, told ASC News in an email. “Quality and excellence are the driving forces behind DISC Surgery Centers and our clinically integrated network.”

The timing of the research carries outsized importance amid broader shifts in spine and musculoskeletal care, Becker added.

“The DISC Surgery Centers continually push the boundaries of what can be performed safely and effectively in an ambulatory setting,” he told ASC News. “Bringing a highly complex procedure like a 360° fusion into our specialized ASCs – where patients can begin their recovery and be discharged in under 23 hours – perfectly illustrates the expanded value we deliver.”

What’s more, Becker described the field as being on the cusp of major advancements.

“The timing of this study is particularly important, as it demonstrates that we are standing at the brink of significant transformation in spine and musculoskeletal care,” he continued. “DISC is helping lead the migration of complex surgeries into the outpatient environment, a shift that promises meaningful benefits for all stakeholders – patients, providers and payers alike.”

As far as patient demographics, the cohort in the study consisted of 125 male and 78 female patients.

ASA scores – a measure of acuity prior to surgery, with lower scores translating to healthier, less-risky individuals – were used to assess patient health status: 76 patients classified as ASA 1, 118 as ASA 2 and six as ASA 3.

The average age of patients was 50.8 years, ranging from 24 to 76 years.

Surgical times ranged from 29 to 320 minutes, with an average OR time of 167 minutes. The average surgical time was 115 minutes, with minimal variation across years.

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