Joan F. O'Shea, MD, a neurosurgeon and orthopedic spine surgeon at The Spine Institute of New Jersey, gave a presentation titled "How to Achieve Great Results for Spine/Neurosurgery in an ASC" at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, 2011. Dr. O'Shea decided to take her spine cases to an ASC because she was frustrated with the inefficiencies in the hospital and she realized the cost reduction potential of utilizing an ASC.
At ASCs, surgeons are in control of the facilities, surgical fees and implants they are able to use. She predicts at least 80 of practicing spine and neurosurgeons are able to perform their cases in the ASC, whether they are currently doing so or not. Not every surgeon is suited for the switch—ASC surgeons must perform quick surgeries, be confident in their surgical ability and have a good support team. She is also careful to select the appropriate patients for cases in the ASC and always provides preoperative planning for the patients so they know what to expect at the surgery center.
For her cases in the ASC, Dr. O'Shea increases patient comfort and decreases the risk of complications by:
• Taking patients off of medications during the preoperative
• Uses cottonoids to stop epidural bleeding
• Uses Decadron to relieve patients of post-operative nausea and vomiting
• Uses cervical traction five to 15 pounds
• Encourages early ambulation to avoid urinary issues
She performs all cases minimally invasively using fluoroscopy and makes incisions right over the surgical site. After the incision, as long as surgeons find the carotid artery, they will be able to access the surgical cite because it is medial from there, she said.
Related Articles on Spine Surgery:
Dr. Richard Hynes: Why a Spine-Focused ASC is Important for the Future of Minimally Invasive Spine Surgery
Dr. Bryan Massoud: Getting Started With Endoscopic Spine Surgery
Dr. James Lynch: The Next 5 Years of Spine Surgery
At ASCs, surgeons are in control of the facilities, surgical fees and implants they are able to use. She predicts at least 80 of practicing spine and neurosurgeons are able to perform their cases in the ASC, whether they are currently doing so or not. Not every surgeon is suited for the switch—ASC surgeons must perform quick surgeries, be confident in their surgical ability and have a good support team. She is also careful to select the appropriate patients for cases in the ASC and always provides preoperative planning for the patients so they know what to expect at the surgery center.
For her cases in the ASC, Dr. O'Shea increases patient comfort and decreases the risk of complications by:
• Taking patients off of medications during the preoperative
• Uses cottonoids to stop epidural bleeding
• Uses Decadron to relieve patients of post-operative nausea and vomiting
• Uses cervical traction five to 15 pounds
• Encourages early ambulation to avoid urinary issues
She performs all cases minimally invasively using fluoroscopy and makes incisions right over the surgical site. After the incision, as long as surgeons find the carotid artery, they will be able to access the surgical cite because it is medial from there, she said.
Related Articles on Spine Surgery:
Dr. Richard Hynes: Why a Spine-Focused ASC is Important for the Future of Minimally Invasive Spine Surgery
Dr. Bryan Massoud: Getting Started With Endoscopic Spine Surgery
Dr. James Lynch: The Next 5 Years of Spine Surgery