Outpatient spine surgery continues to grow as advances in minimally invasive techniques; anesthesia, and perioperative care make more procedures suitable for ambulatory settings. However, according to a recent Becker’s Spine Review report, several challenges continue to limit broader adoption across ambulatory surgery centers (ASCs).
One of the primary barriers cited is patient selection and case complexity. While outpatient spine procedures have expanded, leaders note that not all patients are appropriate candidates for ASC-based care due to comorbidities, surgical risk, and post-operative needs. These factors continue to restrict the number of spine cases that can safely transition out of hospital settings.
Anesthesia availability was also identified as a major limiting factor. Ongoing anesthesia workforce pressures have made it difficult for some ASCs to secure consistent coverage for spine cases. Limited anesthesia availability can restrict block time, slow program growth, and reduce overall operating room utilization.
The report also highlights reimbursement and financial challenges as a key concern. Spine procedures often involve higher costs related to implants, specialized equipment, and staffing. Leaders cited inconsistent payer policies and reimbursement levels that may not fully align with the cost of delivering outpatient spine care, particularly in Medicare and commercial payer environments.
Additionally, infrastructure and capital investment requirements remain a barrier for some facilities. Outpatient spine programs often require advanced imaging, navigation technology, and specialized operating room setups, creating financial hurdles for ASCs considering program expansion.
Operational readiness was another theme emphasized in the report. Successful outpatient spine surgery programs depend on strong coordination between surgeons, anesthesia teams, nursing staff, and administrative operations. Without standardized workflows, efficient scheduling, and aligned processes, growth can be difficult to sustain.
The Becker’s report underscores that while demand for outpatient spine surgery continues to increase, addressing workforce availability, reimbursement alignment, infrastructure investment, and operational coordination will be critical to supporting long-term growth.
