J U N E 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 4 1
O
utpatient spine is here, and it's going
to get bigger — much bigger. The
combination of innovative techniques,
motivated patients, new ways to con-
trol pain and nausea, and financial
incentives are going to make it too attractive to
ignore. John C. Liu, MD, co-director of the USC
Spine Center at Keck Medicine of USC and one of
the pioneers of outpatient spine, will explain what's
needed to succeed, so you don't get left behind.
• The inspiration. Patients and insurance compa-
nies are both driving this trend. Patients obviously
are much happier recovering at home, and insurance
companies want it because it's much less expensive
overall. With the advent of minimally invasive tech-
niques and other innovations, it's become safe to get
people home on the same day.
Considered one
of the pioneers in
minimally invasive
surgical techniques
for spine.
Has had nearly
100 papers pub-
lished on spine pro-
cedures and other
topics.
Named USC
teacher of the year
in 2013.
John C. Liu, MD
Outpatient Spine Is
Surgery's Next Big Thing
Choosing the right patients
and controlling costs are key.
• Pain control. We try
to reduce the use of opi-
ates before the operation.
The more opiate naïve
people are, the better we
can control post-op pain.
We also use intra-opera-
tive techniques, such as
long-lasting local anes-
thetics or cocktails of
steroids and pain medica-
tions. We pre-medicate
with things like
gabapentin and IV aceta-
minophen — membrane-
stabilizing medications.
We send opiates home
with patients, but many
patients — at least with
the smaller operations —
don't end up taking them.
