Study design:

Technical Report.

Objective:

Performing surgeries in the ambulatory surgery center affords improved efficiencies in terms of cost and speed. However, ambulatory surgery is only successful if complications, re-admissions, and re-operations are avoided. This report describes the San Diego Outpatient Lumbar Fusion Program, a culmination of cumulative incremental improvements in patient selection and patient education, meticulous peri-operative management, minimally invasive techniques together with navigation/robotics.

Methods:

Retrospective review of prospectively collected data on 1-2 level minimally invasive transforaminal lumbar interbody fusions (MIS TLIF).

Results:

Healthy patients (age 72 years old or less, BMI less than 50, ASA 1 or 2) with good social support and reasonable pre-operative function (ODI 50 or less) treated with the MIS TLIF technique can be discharged home in less than 1 midnight with good clinical results.

Conclusions:

Relatively young, healthy patients can safely and effectively undergo 1-2 level lumbar fusion surgery in the ASC setting when using contemporary minimally invasive techniques and computer-assisted navigation/robotics.