Becker's ASC Review

14 Executive Briefing Sponsored by: P aradigm Spine's coflex® Interlaminar Stabilization® device is meeting an unmet need in surgical treatment at spine- focused ASCs. The coflex® device provides pain relief with clinical outcomes similar to spinal fusion. However, unlike spinal fusion, coflex® preserves lumbar motion. As CMS continues to approve additional spinal procedures for the ASC setting, coflex® is a clinically appropriate and economical option for ASC administrators everywhere. Becker's ASC Review spoke with several experts about the coflex® Interlaminar Stabilization® device to gain insight into how spine is trending in the ASC setting and how coflex® is revolutionizing spine care. Conversation participants included: • Erich Wolf, MD, PhD a neurosurgeon at Surgicare of Lake Charles (La.) • Paul Jeffords, MD, an orthopedic surgeon at Atlanta-based Resurgens Orthopaedics • Anuj Prasher, MD, a spine surgeon at Stuart-based South Florida Orthopaedics & Sports Medicine • Michael Judge, administrator of Norwood, Ohio-based Mayfield Spine Surgery Center Note: Response have been lightly edited for length and clarity. Question: How is spine trending in the ASC setting, and what impact has it had on you, your facility and your patients? Dr. Erich Wolf: Spine surgery is definitely a growing trend in the ASC setting. With the trend toward minimally invasive surgery we are able to perform increasingly complex spinal surgery in an outpatient setting. This allows our patients to enjoy the benefits of the ASC, that is, convenience, personalized care and lower cost. As a surgeon and shareholder in the ASC, we are the architect of our own environment, allowing us to tailor our daily experience to our personal preference. Dr. Paul Jeffords: The trend over the years has been a greater number of spine cases moving out of the hospital and into the surgery center. I think that's a byproduct of more minimally invasive surgeries, better technologies in terms of spinal implants, better anesthesia techniques and better regimens for postoperative pain control. What that resulted in is a better experience for the patient. When a patient is able to have a surgery at a dedicated outpatient orthopedic and spine center, it's more of a tailored experience for the patient. They're getting more of a boutique experience and are taken care of at a specialty center that's dedicated to that aspect of medicine. Patients have a more efficient experience in terms of check-in and check-out. It's just better overall for the patient, plus they don't have to spend the night in a hospital, which reduces the risk of infection. It's better for the surgeon and better for the patient and as time goes on we're going to see that happening more and more and you'll see a greater number of cases move to the outpatient setting. Michael Judge: For us, patient and surgeon interest in spine surgery continues to grow. We've seen that growth over the 11 years we've been operating as the Mayfield Spine Surgery Center. Patients can be amazed when they hear they can have this type of surgery in the ASC setting. They appreciate the reduction in complexity the day of the surgery. From parking, navigating the building, staying in the same room with the same staff, to even leaving the same day, patients and families appreciate the ASC experience. The surgeons also appreciate the efficiencies we bring operationally along with the specialized experience our staff and the anesthesia team we work with bring, given we've been doing what we've been doing for over a decade. [Focusing on spine was] really a push by the Mayfield practice neurosurgeons. They wanted to make a move that ultimately was what turned into the spine surgery center. Q: In your opinion, why is spine in an ASC so valuable to the healthcare system? Dr. Anuj Prasher: [Spine in an ASC is] definitely more cost effective and cost conscious. Everyone involved in the center is aware of how much all the materials and disposable items we use [cost], so there is very little that goes to waste in the ASC setting. That's why I think [spine-based ASC procedures are] really valuable. We're able to provide the same or better care at a much lower cost in a much more convenient and efficient fashion. EW: Spine surgery in an ASC setting is economically competitive compared with a hospital setting, providing value to payers. A clinical advantage is enjoyed by the ASC since the staff become very familiar with a niche of spinal surgical procedures. Q: How does the coflex® Interlaminar Stabilization® device help improve quality outcomes? EW: The coflex® interlaminar implants have really improved the patient experience following lumbar decompression surgery. The additional segmental stabilization afforded by the implant seems to provide improved patient satisfaction, particularly in cases where adequate decompression may cause decreased stability. AP: [I use] coflex® in my practice mainly for people without significant instability that still have severe spinal stenosis. It's a stabilization device that has been shown to be used safely in patients who have very minimal instability in the setting of severe spinal stenosis. Research has shown it's a very good option to use in those patients because it still provides stability after decompression. PJ: The way I see coflex® is it's a procedure for patients that need more than just a laminectomy but may not necessarily need a fusion. It's that in between option that we've never had in the past. It can be done minimally invasively and as an outpatient. coflex® Ask the experts — Why coflex® is right for your ASC

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