Intraoperative and Postoperative Safety of Outpatient Anterior Lumbar Spine Surgery: A Multicenter Experience

BACKGROUND: Outpatient spine surgery has expanded over the past decade, but this transition has largely involved anterior cervical procedures. Safety data regarding anterior lumbar interbody fusion (ALIF) and artificial disc replacement (ADR) performed in ambulatory surgery centers remain limited. OBJECTIVE: In this study, we investigated the safety and efficacy of anterior lumbar surgeries in outpatient settings based on operative and early postoperative outcomes. METHODS: A total of 33 patients underwent anterior lumbar surgery: ALIF or of 1 to 3 levels. Patient data were collected and analyzed from patient records of 2 ambulatory surgery centers. We specifically evaluated blood loss, operative and postoperative complications, procedure length, demographics, comorbidities, and the type of procedure. RESULTS: No patients had operative or early postoperative complications, and none were admitted or transferred to a hospital for further care. Blood loss in all patients remained within minimal limits. CONCLUSION: Based on patient outcomes, lumbar surgeries with an anterior approach can be safely performed by a qualified team consisting of a vascular surgeon and spine surgeon in an outpatient surgical facility, such as an ambulatory surgery center. CLINICAL RELEVANCE: These findings support the feasibility and safety of performing ALIF and ADR in carefully selected patients within an ambulatory surgery center, provided the procedure is carried out by an experienced spine and vascular/cardiothoracic surgical team with appropriate perioperative protocols and hospital transfer arrangements.