When DISC officially released the findings of its six-year retrospective study on the safety and efficiency of outpatient 360° fusion surgery, the data said it all. Of the 203 consecutive 360° fusions performed in an ambulatory setting, 100% of patients were discharged within 23 hours with zero hospital transfers or immediate readmissions.
This meant that not only could one of the most complex spine surgeries be performed safely as an outpatient procedure, but doing so also represented a huge cost savings – estimated annual savings of $800 million to $1.2 billion – to the healthcare system.
DISC’s findings were so compelling that the LA Times Studios reporter Kevin Famuyiro knew he had to write a story about the study’s implications. We had him sit down with some of our key doctors and leadership for what became an expansive feature.
“We are used to the industry hype cycle. Every year, a new technique promises to revolutionize spine care, and every year, we go back to the O.R. and do mostly the same things. But the migration of the 360° lumbar fusion to the outpatient setting feels different,” Famuyiro wrote. “It feels inevitable. Advances in surgical techniques, anesthesia, and postoperative care have made it possible for many patients to safely undergo spine surgery and return home the same day.”
He delved into the retrospective study, authored by DISC orthopedic spine surgeon Steven J. Girdler, MD, before asking the question, “How?... Is it luck? Or is it engineering?”
And even though Famuyiro highlighted the efficiency of operating time (a tight 167 minutes), he described the real “magic” as not just speed. “Early mobilization, including getting patients out of bed and walking soon after surgery, has become a standard part of outpatient spine care.”
He then looked to DISC orthopedic surgeon Rojeh Melikian, MD for context.
“A 360° spinal fusion is one of the most complex spinal fusions because it involves accessing both the front (anterior) and back (posterior) parts of your spine,” Melikian said. “A decade ago, a complex, multistage surgery like the 360° fusion would have been done at the hospital with a lengthier stay.”
With patients home in less than a day, they avoid issues like infections, clots and the lethargy of the inpatient ward.
Famuyiro’s article went on to highlight the growing number of spinal procedures being migrated from hospitals to surgery centers.
“It isn’t just about big fusions,” he wrote. “The shift to the ambulatory surgery center covers the whole spectrum. You have your lumbar decompression. You have your anterior cervical discectomy. Even complex cervical spine work is moving out of the main building. Common outpatient spine procedures include anterior cervical discectomy and fusion (ACDF), microlumbar discectomy (MLD), lumbar laminectomy, posterior cervical foraminotomy, and cervical disc arthroplasty.”
And while Famuyiro acknowledged that outpatient spine surgery requires a meticulous attention to detail and real good surgeons who are flawless in their technique, the quality of the outcomes and undeniable cost-savings (some 50-70% per episode) are impossible to ignore, but not every surgery center can do it.
His article described the minimally invasive skill, staff training, infrastructure, protocols and patient selection that set apart a highly specialized surgery center like DISC from others in successfully migrating complex spine from hospitals.
“The data from this study proves the 23-hour 360° fusion is safe. But only if you build the machine to support it. For the rest of the market, it’s a warning: Adapt your infrastructure, or get left with the cases nobody else wants,” Famuyiro wrote.
Read the full LA Times article HERE.
Schedule an appointment with Dr. Girdler HERE.
Schedule an appointment with Dr. Melikian HERE.
