PMID- 30364904
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2211-4599 (Print)
IS  - 2211-4599 (Electronic)
IS  - 2211-4599 (Linking)
VI  - 12
IP  - 5
DP  - 2018 Oct
TI  - Safety and Efficiency of Cervical Disc Arthroplasty in Ambulatory Surgery Centers 
      vs. Hospital Settings.
PG  - 557-564
LID - 10.14444/5068 [doi]
AB  - BACKGROUND: Outpatient surgery has been shown safe and effective for anterior 
      cervical discectomy and fusion (ACDF), and more recently, for 1-level cervical 
      disc arthroplasty (CDA). The purpose of this analysis is to compare the safety 
      and efficiency of 1-level and 2-level CDA performed in an ambulatory surgery 
      center (ASC) and in a hospital setting. METHODS: The study was a retrospective 
      collection and analysis of data from consecutive CDA patients treated in ASCs 
      compared to a historical control group of patients treated in hospital settings 
      who were classified as outpatient (0 or 1-night stay) or inpatient (2 or more 
      nights). Surgery time, blood loss, return to work, adverse events (AEs), and 
      subsequent surgeries were compared. RESULTS: The sample consisted of 145 ASC 
      patients, 348 hospital outpatients, and 65 hospital inpatients. A greater 
      proportion of 2-level surgeries were performed in hospital than ASC. Surgery 
      times were significantly shorter in ASCs than outpatient or inpatient 1-level 
      (63.6 +/- 21.6, 86.5 +/- 35.8, and 116.7 +/- 48.4 minutes, respectively) and 2-level 
      (92.4 +/- 37.3, 126.7 +/- 43.8, and 140.3 +/- 54.5 minutes, respectively) surgeries. 
      Estimated blood loss was also significantly less in ASC than outpatient and 
      inpatient 1-level (18.5 +/- 30.6, 43.7 +/- 35.9, and 85.7 +/- 98.0 mL, respectively) 
      and 2-level (21.1 +/- 12.3, 67.8 +/- 94.9, and 64.9 +/- 66.1 mL). There were no 
      hospital admissions and no subsequent surgeries among ASC patients. ASC patients 
      had 1 AE (0.7%) and hospital patients had 10 AEs (2.4%). Working patients 
      returned to work after a similar number of days off, but fewer ASC patients had 
      returned to work by the end of the 90-day period. CONCLUSIONS: Both 1- and 
      2-level CDA may be performed safely in an ASC. Surgeries in ASCs are of shorter 
      duration and performed with less blood loss without increased AEs.
FAU - Gornet, Matthew F
AU  - Gornet MF
AD  - The Orthopedic Center of St Louise, St Louis, Missouri.
FAU - Buttermann, Glenn R
AU  - Buttermann GR
AD  - Midwest Spine & Brain Institute, Stillwater, Minnesota.
FAU - Wohns, Richard
AU  - Wohns R
AD  - NeoSpine, Puyallup, Washington.
FAU - Billinghurst, Jason
AU  - Billinghurst J
AD  - Orthopedic Center of Palm Beach County, Atlantis, Florida.
FAU - Brett, Darrell C
AU  - Brett DC
AD  - Northwest Spine Surgery, Portland, Oregon.
FAU - Kube, Richard
AU  - Kube R
AD  - Prairie Spine and Pain Institute, Peoria, Illinois.
FAU - Rafe Sales, J
AU  - Rafe Sales J
AD  - Northwest Spine & Laser Center, LLC, Portland, Oregon.
FAU - Wills, Nicholas J
AU  - Wills NJ
AD  - Summit Orthopedics, Eagan, Minnesota.
FAU - Sherban, Ross
AU  - Sherban R
AD  - Sherban Spine Institute, Boynton Beach, Florida.
FAU - Schranck, Francine W
AU  - Schranck FW
AD  - SPIRITT Research, St Louis, Missouri.
FAU - Copay, Anne G
AU  - Copay AG
AD  - SPIRITT Research, St Louis, Missouri.
LA  - eng
PT  - Journal Article
DEP - 20181015
PL  - Netherlands
TA  - Int J Spine Surg
JT  - International journal of spine surgery
JID - 101579005
PMC - PMC6198634
OTO - NOTNLM
OT  - ambulatory surgery center
OT  - cervical disc arthroplasty
OT  - outpatient surgery
OT  - total disc replacement
COIS- Disclosures and COI: The device manufacturer, Zimmer Biomet (formerly LDR Spine), 
      sponsored the Mobi-C Cervical Disc ASC Study. Zimmer Biomet contributed to the 
      design and conduct of the study, and provided assistance with analysis of data 
      and manuscript review. The authors also report receiving writing or editorial 
      assistance for this paper from Zimmer Biomet. These authors report the following 
      potential or perceived conflicts: M.F. Gornet reports consulting for Aesculap and 
      Medtronic; stockownership of Bonovo, International Spine & Orthopedic Institute, 
      LLC, Nocimed, OuroBoros, Paradigm Spine; and royalties from Medtronic and RTI. R. 
      Kube reports research support from Zimmer Biomet and consulting for Paradigm 
      Spine. R. Sherban reports consulting for Zimmer Biomet. N.J. Wills reports 
      consulting for Zimmer Biomet and Medtronic. F.W. Schranck reports stockownership: 
      Nocimed.
EDAT- 2018/10/27 06:00
MHDA- 2018/10/27 06:01
PMCR- 2018/10/15
CRDT- 2018/10/27 06:00
PHST- 2018/10/27 06:00 [entrez]
PHST- 2018/10/27 06:00 [pubmed]
PHST- 2018/10/27 06:01 [medline]
PHST- 2018/10/15 00:00 [pmc-release]
AID - 10.14444/5068 [doi]
PST - epublish
SO  - Int J Spine Surg. 2018 Oct 15;12(5):557-564. doi: 10.14444/5068. eCollection 2018 
      Oct.