Becker’s Spine Review has come out with its list of the 10 most pressing issues in spine surgery for 2013. Of course, these issues also continue into 2014. We have chosen our top three trends, and some thoughts on them. Our top three trends are as follows:
1. Minimally invasive vs. open fusion. Researchers at the Rothman Institute at Thomas Jefferson University in Philadelphia published a study comparing minimally invasive and open techniques for posterior lumbar instrumentation and fusion, and found MIS to be bring less blood loss and shorter hospital stays.
Microsurgical Spine Center (MSC) Thoughts: As an ambulatory surgery center (ASC), we specialize in minimally invasive and outpatient procedures. Our facility is regulated by processes that include state licensure, voluntary accreditation and Medicare certification. Studies show that this attention to quality enables ASCs to outperform hospitals when it comes to clinical outcomes and patient satisfaction—and this research from the Rothman Institute confirms this fact.
In addition, there are over 5,000 ASCs across the country, and with each one comes more patient choice. As the industry grows, so does the list of both outpatient surgeries and non-surgical procedures and treatments available in a local, personalized setting. Another advantage of ambulatory surgery is scheduling, and resources are more efficient, which means fewer surgery delays for patients. In a hospital, your procedure can be bumped due to emergency situations or other scheduling conflicts.
Being smaller in size and scope than a hospital, MSC can focus solely on our patients and their comfort—another benefit of an ASC. The infection rate is so low it is almost nonexistent. Over 50% of ASCs have an infection rate of 0%.
2. Bundled payments for spine surgery. Several industry experts looked at what’s on the horizon for bundled spine payments and how providers can prepare.
MSC Thoughts: ASCs work to provide the best surgical experience possible at a lower cost to patients. Because they are more efficient when it comes to same-day surgery, patients typically pay less co-insurance at an ASC for the same procedure received in a hospital setting. And patients don’t have to wait to see the savings. In an effort to make pricing more transparent, cost information is generally available to patients prior to surgery.
MSC accepts Medicare and many major insurance plans. However, for patients who are not covered or for patients who are coming from Canada for surgery, we do offer bundled payment. To learn more about our VIP Experience and bundled payment, please click here.
3. North American Spine Society (NASS) defends spinal fusions. The NASS Executive Committee penned a letter to the Washington Post in response to a story about the necessity of spinal fusions.
MSC Thoughts: Spinal fusion is becoming a hot-button issue in the medical community. Physicians who recommend spinal fusion, or any other spine procedure, have carefully considered all options and worked closely with the patient on an individual level to find the best solution for their pain. The reality of the situation is stated in the letter, that “pain in the lower back is the #1 cause of disability in the United States and worldwide. Neck pain is #4.” There is no one-size-fits-all solution to back pain but the struggles with back pain for many people are all too real—not to mention difficult.
We agree with the NASS that, “As in ALL surgical procedures, the key is the surgical indication for the individual patient. Overuse or underuse are both bad medicine and do the patient a disservice. There is universal support for spinal fusion in cases of instability, fracture, tumor, infection and deformity.”
Some of the objections to spinal fusion include that complex fusions can cause life-threatening complications, and patients did not experience pain relief after surgery. However, this finding is only on invasive procedures. These complications were not from minimally invasive surgery.