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Practice Policy Update Regarding COVID-19

Outpatient Spine Surgery

Jeremy S. Smith, M.D., Orthopaedic Spine Surgeon, Orange CA / Patient Info / Spine / Spine Procedures / General / Outpatient Spine Surgery
Outpatient Spine Surgery

Outpatient spine surgery is an operative procedure that does not require an overnight stay at the hospital. It is also called ambulatory or same-day surgery. Improvement in surgical techniques, modern pain management, and rehabilitation protocols allows surgeons to perform certain operative techniques of the spine (from cervical to lumbar region), with a minimally invasive technique on an outpatient basis.

Minimally invasive spine surgery (MISS) is performed through small incisions. It involves the use of special surgical instruments, devices and advanced imaging techniques to visualize and perform the surgery through those small incisions.

Am I a Suitable Candidate for Outpatient Spine Surgery?

You may be a good candidate for outpatient spine surgery if you are healthy and do not have medical conditions such as diabetes, uncontrolled seizure disorders, respiratory problems, and certain sleep disorders. A high level of motivation during the rehabilitation process and good family support is required after the surgery.

Indications for Outpatient Spine Surgery

Outpatient spine surgery is indicated for the following spine conditions:

  • Disc replacement surgery
  • Degenerative disc disease
  • Spinal fusion
  • Spondylolisthesis
  • Disc arthroplasty
  • Cervical discectomy and fusion
  • Spinal stenosis

Preparing for Outpatient Spine Surgery

Talk to your doctor about the medicines you are taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. You will need to arrange for someone to drive you home after the surgery.

Outpatient Spine Surgery Procedure

The procedure may be performed under local or regional anesthesia and involves the following steps:

  • You will lie on your back, side or stomach depending upon the approach required to access the operative area.
  • Your surgeon makes a few small incisions over the area guided by fluoroscopy or live X-ray.
  • Segmental tubular retractors and dilators are then inserted through these small incisions to retract or move aside muscles and provide access to the spine by creating a working channel for the surgery. This minimizes the damage to the muscles and soft tissues and decreases blood loss during the surgery.
  • An endoscope is inserted through one of the incisions to provide images of the operation field which is projected onto the monitor in the operation room for the surgeon to view.
  • The surgery is performed with special surgical instruments passed through the working channel. Sometimes, surgical microscopes may also be used to magnify the visual field.
  • Once the operation is complete, the surgeon withdraws the various instruments. The tissues will fall back in place, as the various instruments are withdrawn.
  • The incision is then closed and dressed.

Complications of Outpatient Spine Surgery

Complications are rare but can include infection, bleeding, nerve damage, or spinal cord injury.

Advantages of Outpatient Spine Surgery

The advantages of outpatient spine surgery over the traditional open surgery include:

  • Outpatient surgery does not involve a large incision or IV pain medicines. Hence, it causes less pain.
  • There is no need for a blood transfusion.
  • There is no need for an overnight hospital stay and you are allowed to recover at home. A nurse or healthcare provider will monitor your health as instructed by your surgeon.
  • The cost of outpatient spine surgery is less since there are no hospital room and other charges.
  • There is less risk of acquired hospital infections since you will recover at home.
  • You can recover better in a home setting with care and interaction from your family and friends.
  • Your physical therapist will teach you specific physical exercises to improve your flexibility and movement as you heal.

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