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Research ArticleLumbar Spine

Safety of Outpatient Anterior Lumbar Interbody Fusion Surgery: A Systematic Review With Meta-Analyses

Luke J. Weisbrod, Brandon L. Staple, Danielle M. Westmark, Andrew P. Gard and Daniel L. Surdell
International Journal of Spine Surgery December 2024, 18 (6) 705-711; DOI: https://doi.org/10.14444/8661
Luke J. Weisbrod
1 Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, USA
MD
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  • For correspondence: Luke.weisbrod@unmc.edu
Brandon L. Staple
2 School of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
BS
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Danielle M. Westmark
3 University of Nebraska Medical Center, Leon S. McGoogan Health Sciences Library, Omaha, NE, USA
BS
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Andrew P. Gard
4 MD West ONE Neurosurgery, Omaha, NE, USA
MD
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Daniel L. Surdell
1 Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, USA
MD
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    Figure 1

    Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart.

  • Figure 2
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    Figure 2

    Forest plot demonstrating random effects model for postoperative adverse events in patients who underwent anterior lumbar interbody fusion surgery in the outpatient setting compared with the inpatient setting. RE, random effects.

  • Figure 3
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    Figure 3

    Forest plot demonstrating fixed effects model for postoperative readmission rate in patients who underwent anterior lumbar interbody fusion surgery in the outpatient setting compared with the inpatient setting. The time in parentheses denotes over what follow-up period the readmission rate was recorded. FE, fixed effects.

  • Figure 4
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    Figure 4

    Forest plot demonstrating fixed effects model for postoperative reoperation rate in patients who underwent anterior lumbar interbody fusion surgery in the outpatient setting compared with the inpatient setting. The timing in parentheses denotes over what follow-up period the reoperation rate was recorded. FE, fixed effects.

Tables

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    Table 1

    Characteristics of studies included in meta-analyses.

    StudyStudy YearStudy DesignStudy LocationNOSFollow-up Duration
    Jones11 2022RetrospectiveUSA730 d
    Snowden12 2020RetrospectiveUSA824 mo
    Cuellar13 2021RetrospectiveUSA890 d
    Kamalapathy14 2022RetrospectiveUSA890 d
    • Abbreviation: NOS, Newcastle-Ottawa Score.

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    Table 2

    Characteristics of patient demographics included in meta-analyses.

    StudyNo. of PatientsMean Age, yLevel(s)Posterior Instrumentation
    OutpatientInpatientOutpatientInpatient
    Jones11 1493579NANA1N
    Snowden12 293344.251.61Y
    Cuellar13 12410243.647.61–3N
    Kamalapathy14 17688840NANA1NA
    • Abbreviations: N, no; NA, not available; Y, yes.

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    Table 3

    Adverse events of patients included in meta-analyses.

    Adverse EventsOutpatient (N = 2070)Inpatient (N = 12,554)
    No. of patients with any adverse event1651453
    Death04
    Vascular injury<1155
    Sepsis<1199
    Septic shock02
    Deep venous thrombosis17151
    Myocardial infarction<1131
    Cardiac arrest03
    Stroke<1116
    Acute kidney injury13106
    Acute renal failure04
    Postoperative ventilator use >48 h05
    Pulmonary embolus<1279
    Unplanned reintubation15
    SSI36318
    Wound complication48374
    Wound dehiscence05
    Organ/space SSI012
    Deep SSI012
    Nausea/vomiting<1143
    Urinary retention<11100
    Urinary tract infection47376
    Bleeding requiring transfusion<11167
    Pneumonia20174
    Progressive renal insufficiency02
    Superficial SSI130
    Hematoma<1138
    Hematoma/seroma22
    Nerve root injury01
    Complex regional pain syndrome01
    Intraoperative dural tear<1133
    • Abbreviation: SSI, surgical site infection.

    • View popup
    Table 4

    Outcome measures of studies included in meta-analyses.

    StudyOutpatientInpatientAdverse Events OutpatientAdverse Events Inpatient P
    Jones11 149357933280.003
    Snowden12 293335>0.05
    Cuellar13 12410217>0.05
    Kamalapathy14 176888401581113<0.001
    StudyOutpatientInpatientReturn Admission OutpatientReturn Admission Inpatient P
    Jones11 149357961660.727
    Snowden12 2933NANANA
    Cuellar13 12410222>0.05
    Kamalapathy14 176888401457040.865
    StudyOutpatientInpatientReoperation OutpatientReoperation Inpatient P
    Jones11 14935791920.145
    Snowden12 29331720>0.05
    Cuellar13 12410201>0.05
    Kamalapathy14 17688840201500.073
    • Abbreviation: NA, not available.

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International Journal of Spine Surgery
Vol. 18, Issue 6
1 Dec 2024
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Safety of Outpatient Anterior Lumbar Interbody Fusion Surgery: A Systematic Review With Meta-Analyses
Luke J. Weisbrod, Brandon L. Staple, Danielle M. Westmark, Andrew P. Gard, Daniel L. Surdell
International Journal of Spine Surgery Dec 2024, 18 (6) 705-711; DOI: 10.14444/8661

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Safety of Outpatient Anterior Lumbar Interbody Fusion Surgery: A Systematic Review With Meta-Analyses
Luke J. Weisbrod, Brandon L. Staple, Danielle M. Westmark, Andrew P. Gard, Daniel L. Surdell
International Journal of Spine Surgery Dec 2024, 18 (6) 705-711; DOI: 10.14444/8661
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  • Recovery Trajectories After Lumbar Fusion Stratified by Baseline Patient-Reported Outcomes Measurement Information System Physical Function Disability Levels
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Keywords

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  • outpatient
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