Anterior cervical discectomy and fusion (ACDF) remains a primary surgical solution for various degenerative cervical spine pathologies. Historically, surgeons preferred inpatient settings to monitor for rare but serious postoperative complications like hematoma or respiratory distress. However, the modern push toward value-based healthcare has shifted many of these procedures to ambulatory settings. A recent multi-institutional registry study evaluated outpatient ACDF outcomes to see if this shift impacts patient satisfaction or clinical success.

Evaluating Outpatient ACDF Outcomes and Safety

The research team retrospectively reviewed data from 1,514 patients who underwent ACDF between 2016 and 2023. This cohort included 1,052 outpatients and 462 inpatients. Initially, the outpatient group appeared younger and had a lower Body Mass Index (BMI) compared to the inpatient group. To ensure a fair comparison, the authors used propensity score overlap weighting to balance these baseline differences. Consequently, the study provided a robust assessment of how the surgical setting alone influenced recovery.

Furthermore, the study measured results using standardized tools, including the North American Spine Society (NASS) outcome assessment and the 10-item Eating Assessment Tool (EAT-10). Researchers collected patient-reported outcome measures (PROMs) preoperatively and at intervals of 3 and 12 months. Notably, the analysis revealed no significant differences in patient satisfaction or dysphagia levels between the two groups at any postoperative stage. This suggests that discharging a patient on the same day does not diminish the perceived quality of care or the physiological recovery process.

Clinical Implications for Spine Surgery

The study found that both settings yielded similar complication rates and functional improvements. Moreover, there were no meaningful differences in 12-month satisfaction scores, with most patients in both cohorts reporting high levels of contentment with their surgical results. These findings provide strong evidence that outpatient ACDF is a viable and effective option for properly selected candidates. Surgeons can confidently offer same-day discharge without worrying about compromising long-term patient-reported success.

In conclusion, the transition to outpatient spine care appears well-supported by high-quality registry data. As long as patient selection criteria remain stringent, the move toward ambulatory surgery centers can maintain the high standards of care established in traditional hospital settings. Future research may further refine which specific comorbidities most significantly impact the safety of same-day discharge.

Frequently Asked Questions

Is it safe to have ACDF as an outpatient procedure?

Yes, for carefully selected patients, outpatient ACDF is considered safe. Large-scale studies show that complication and readmission rates are comparable to those of inpatient procedures when proper protocols are followed.

Do outpatients feel less satisfied with their care?

According to this multicenter study, there is no difference in long-term patient satisfaction between those who stay overnight and those who go home the same day. Both groups reported similar functional improvements and satisfaction levels at one year.

What are the main benefits of same-day discharge for ACDF?

The primary benefits include recovering in the comfort of one's own home, reduced healthcare costs, and a more streamlined surgical experience. These benefits are achieved without a significant increase in the risk of dysphagia or other common complications.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

Potts AJ et al. Do patients undergoing anterior cervical discectomy and fusion in the outpatient setting have better self-reported outcomes? A propensity-weighted multicenter registry study. Neurosurg Focus. 2026 Apr 01. doi: 10.3171/2026.1.FOCUS251102. PMID: 41921230.

Ding L, Yin M, Yuan W. Safety of outpatient vs. inpatient anterior cervical discectomy and fusion: a systematic review and meta-analysis. PeerJ. 2025 Sep 22;13:e20045. doi: 10.7717/peerj.20045.