ASCs for Spine: How Medical Device Manufacturers Can Improve Accuracy and Efficiency
Spine surgeries have been slower to transition to an outpatient setting because of their complexity. However, some spine procedures are now considered lower risk and safe for Ambulatory Surgery Centers (ASC).
For example, a survey found that 86% of spine surgeons expected lumbar discectomies to move to ASCs at accelerating rates over the next few years. A similar trend is predicted for cervical-lumbar decompressions. This is only possible due to the incredible advances in surgical techniques, pain management, medical imaging, and medical device technologies.
The movement of spine surgeries towards ASCs is not surprising. The United States healthcare system is now more focused on value-based care than ever, and outpatient procedures are becoming increasingly popular. They are already a preferred setting for outpatient hip and knee arthroplasty. Almost half of all primary joint arthroplasties are expected to be performed in an ASC setting by 2026. These total joint procedures now demonstrate similar outcomes in an ASC vs. an inpatient setting and are cost-effective for payors. The appropriate spine procedures will be sure to follow in joint arthroplasty’s footsteps.
A Bain study found that this demand for ASC spine procedures has spurred the proliferation in spine centers – a 314% increase from 2013 to 2019. The study estimates that ASCs will contribute to 30% of all spine surgeries by the mid-2020’s. A survey of spine surgeons in the United States found that over 84.2% performed ambulatory surgeries in some capacity.
Factors driving Growth in Spine ASC Surgery
Several factors are strong contributors to the growth of Spine ASC surgery. These include:
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Enhanced Surgical Techniques
The increased usage of minimally invasive techniques in spine surgery is a significant reason. The potential for lower postoperative pain and faster recovery after surgery due to smaller incisions have made this type of surgery increasingly popular. These surgeries are also common for lower-risk spine procedures. This makes such surgeries ideal candidates for an ASC setting. Technological advances like computer-guided navigation and robot-assisted surgeries allow surgeons to navigate intraoperative challenges they may face with smaller incisions. This helps improve patient outcomes and satisfaction after spine procedures. -
Lower Costs
Surgery in an ASC setting also costs less for patients and payors compared to an inpatient procedure. A study on single-level anterior cervical discectomy and fusion (ACDF) procedures found that the mean 90-day cost for an outpatient setting was $8000 lower than inpatient admission. Similarly, another study of 150,000 patients undergoing lumbar discectomy in the United States found a 50% reduction in costs in an outpatient procedure versus an inpatient setting. -
Patient Preference For At-Home Recovery
The ability to recuperate at home versus a hospital setting after surgery is also highly appealing to many patients. The familiarity of surroundings, access to resources and social support, and reduced potential for hospital-acquired infections are attractive factors. Surveys conducted indicate patient satisfaction levels at 92% in an ASC setting across procedures. In time, we will have better long-term data regarding the satisfaction after ASC spine procedures specifically. -
Growing Elderly Population
The elderly patient population is expected to constitute 20.6% of the total population by 2030. This demographic, in general, has a greater need for spine surgery procedures as they tend to have more degenerative spinal disorders.
Challenges for Spine Surgeons Due To Rising Demand for ASC Procedures
The rising demand for spine surgery shines a massive spotlight on the accuracy and efficiency of the surgical process.
A thorough assessment of patient preoperative conditions is needed to identify the right patient for the right type of setting - ASC or inpatient. Factors to be considered include comorbidities, surgery type, and level of invasiveness for the procedure. This care during patient selection is even more significant when evaluating patient frailty in elderly patients since they tend to have one or more comorbidities.
Medical device companies need to think beyond their standard products. Offering comprehensive solutions to the overarching issues affecting spine surgeons is the key to surviving in a fast-evolving market.
Apart from streamlining the preoperative patient selection process, medical device manufacturers who help surgeons increase the efficiency of their entire surgical workflow – preop to postop – will be most valuable.
An intelligent, comprehensive surgical ecosystem powered by Artificial Intelligence (AI) is a key solution.
Leveraging the Power of AI for an Intelligent Surgical Ecosystem
Spine surgeons are faced with increasing caseloads and a push for more efficiency. An AI-driven intelligent surgical ecosystem can help surgeons navigate these challenges throughout their workflow. A decision-support tool can help them assess preoperative risk more accurately and efficiently.
As procedure volumes grow, medical device manufacturers will have to streamline their internal processes to stay competitive. For example, an AI-powered surgical platform can help significantly improve the surgical planning process. Currently, developing a 3D anatomic model from 2D imaging is mainly manual. AI can create more accurate 3D anatomic models faster and more efficiently.
This gives surgeons much better visibility into a patient’s anatomy to better evaluate preoperative risk.
An AI surgical platform can help medical device companies improve the overall surgeon experience during preoperative planning. Currently, there is significant back-and-forth communication between the operating surgeon and the medical device company before final approval. Surgeons can collaborate on preop plans and find all relevant information at their fingertips whenever they need it with the right platform.
These 3D anatomic models are the foundation for 3D printed technology and personalized implants and instruments. Patient-specific implants (PSI) can help improve patient outcomes. This is especially true in more complex cases where there is an implant-bone mismatch with traditional off-the-shelf implants. Additionally, PSI reduces the number of instruments required intraoperatively, which can help lower costs and improve efficiency.
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