Issue link: https://beckershealthcare.uberflip.com/i/1518468
7 SPINE Spinal fusions in hospitals vs. ASCs: Which is better? By Carly Behm Spinal fusions can be performed in ASCs or hospitals but there are different considerations when deciding the best setting for the procedure. Five notes: 1. On average CMS covers more for the costs for fusion of lower spine bones, posterior or posterolateral approach (Code 22612) at a hospital outpatient department compared to an ASC. ASC Total cost: $10,267 Medicare pays: $8,214 Patient pays: $2,053 HOPD Total cost: $13,560 Medicare pays: $11,820 Patient pays: $1,740 2. Fusion of lower spine bones, posterior or posterolateral approach also costs more at an ASC compared to an HOPD. ASC: $3,016 HOPD: $1,944 3. Anterior cervical discectomy and fusion costs significantly less when done at ASCs than the hospital setting for Medicare and privately insured patients, according to a study published in the Dec. 15 edition of Spine. Total costs for spinal fusion in the ASC at one year were $5,879.46, compared with $12,873.97 for procedures in the hospital. Researchers concluded, "e ASC setting is a dominant option from a health economy perspective for first-time one-level to two-level ACDF in select patients compared to the inpatient hospital setting." 4. Outpatient and inpatient complications rates for anterior lumbar spinal surgery were similar, according to a study published Dec. 3 in the International Journal of Spine Surgery. Researchers analyzed 226 consecutive anterior lumbar surgeries in an ASC or inpatient tertiary care hospital. ey found 90-day readmission rates were lower for outpatient spinal fusion patients and concluded that, "Our results demonstrate that anterior lumbar procedures, including single-level and multilevel ALIF, ADR, and hybrid procedures, can be performed safely in an ASC. is has significant cost savings implications for the ASC setting." 5. Outpatient cervical and lumbar fusions grew at hospital outpatient departments aer CMS approved the procedures for ASCs while the procedure rate had little or no growth in surgery centers, according to a 2022 Advisory Board report. Researchers found that procedures typically shied outpatient slowly, and HOPD use increased at a higher rate than ASCs. n Dr. Stanley Hoang debuts awake spine surgery at Ochsner LSU Health Shreveport By Carly Behm S tanley Hoang, MD, performed LSU Health Shreveport's (La.) first awake spine surgery, ABC affiliate KTBS reported March 14. Dr. Hoang performed a minimally invasive discectomy with local anesthesia, the report said. The patient was numbed from the waist down, and he was able to go home the same day after the anesthesia wore off. "Awake spine surgery is good for people with issues that preclude having general anesthesia," Dr. Hoang said in the report. "People with severe COPD or severe cardiac failure cannot tolerate having general anesthesia. This would be a great option for them." Dr. Hoang has been at the forefront of spinal innovation at the hospital. In April 2023 he performed the first robot- assisted single position prone lumbar fusion surgery in Louisiana. n Dr. Timur Urakov performs discectomy on NBA player By Carly Behm Brooklyn Nets guard and forward Ben Simmons had a microscopic partial discectomy, the team said March 14. Timur Urakov, MD, performed the surgery in consultation with Barth Green, MD, to alleviate a nerve impingement in his lower back, according to a post on X, formerly known as Twitter. The procedure was done at UHealth Jackson Memorial Medical Center in Miami Gardens, Fla. Mr. Simmons is expected to recover in time for training camp next season, the team said. This is the second time he had back surgery since joining the team, The Score reported. n