{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:16Z","timestamp":1780131916782,"version":"3.54.0"},"reference-count":80,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Anterior cervical discectomy and fusion (ACDF) is commonly performed in both inpatient and outpatient settings. In this study, the authors evaluate the influence of surgical setting on patient-reported outcome measures (PROMs), satisfaction, dysphagia, and complications following ACDF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A prospectively collected, multi-institutional quality improvement registry was retrospectively reviewed. Patients eligible for study inclusion were those who underwent ACDF without corpectomy or arthroplasty between 2016 and 2023. The patients were stratified by surgery setting, with same-day discharge indicating outpatients and an overnight stay indicating inpatients. PROMs were collected preoperatively and at 3 and 12 months postoperatively. Patient satisfaction was measured using the North American Spine Society (NASS) outcome assessment questionnaire, and dysphagia was measured using the 10-item Eating Assessment Tool (EAT-10). Propensity score overlap weighting (average treatment effect in the overlap population) was used to balance baseline covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 1514 patients who underwent ACDF, 462 were inpatients and 1052 were outpatients. The outpatient cohort was younger (55.1 \u00b1 10.7 vs 60.5 \u00b1 11.0 years, p &lt; 0.001), had higher rates of private insurance (73% vs 52%, p &lt; 0.001), had a lower mean American Society of Anesthesiologists (ASA) physical status (2.3 \u00b1 0.6 vs 2.6 \u00b1 0.6, p &lt; 0.001), and underwent more single-level surgeries (53% vs 33%, p &lt; 0.001). Propensity weighting resulted in comparable mean ages (58.9, p &gt; 0.9) and ASA classes (2.5, p = 0.8) as well as private insurance rates (56%, p &gt; 0.9) between the cohorts. After weighting, the inpatient cohort had a higher share of single-level fusions (46% vs 37%, p = 0.007). An outpatient status was associated with significantly better 12-month numeric rating scale (NRS) scores for neck pain (2.4 \u00b1 2.7 vs 3.1 \u00b1 3.0, p = 0.006), NRS scores for arm pain (1.7 \u00b1 2.6 vs 2.2 \u00b1 3.0, p = 0.047), and Neck Disability Index (NDI; 7.7 \u00b1 7.8 vs 9.8 \u00b1 9.4, p = 0.004) and greater improvement from baseline to 12 months on the NDI (\u221212.5 \u00b1 9.7 vs \u221210.8 \u00b1 10.5, p = 0.017), EQ-5D (0.242 \u00b1 0.220 vs 0.209 \u00b1 0.226, p = 0.047), and EQ visual analog scale (10.6 \u00b1 21.6 vs 7.1 \u00b1 20.8, p = 0.012). Fewer outpatients reported dysphagia at 3 months postoperatively (31% vs 40%, p = 0.010). No differences were observed in readmissions or revision procedures, although fewer outpatients experienced new neurological deficits (1.0% vs 2.6%, p = 0.032) and pneumonia (&lt; 0.1% vs 0.9%, p &lt; 0.001). In terms of the 12-month NASS outcome assessment, a smaller proportion of the outpatient cohort reported the lowest satisfaction score (3.9% vs 8.0%, p = 0.019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Outpatient setting was associated with better PROMs at the 12-month follow-up when patients were weighted by baseline health status. These findings support the efficacy of outpatient ACDF in appropriately selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.focus251102","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T02:27:20Z","timestamp":1775010440000},"page":"E3","source":"Crossref","is-referenced-by-count":0,"title":["Do patients undergoing anterior cervical discectomy and fusion in the outpatient setting have better self-reported outcomes? A propensity-weighted multicenter registry study"],"prefix":"10.3171","volume":"60","author":[{"given":"Alexander J.","family":"Potts","sequence":"first","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan C.","family":"Rezner","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen M.","family":"Hannon","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey R.","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Department of Neurosurgery, Ascension St. Vincent Hospital, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adison M.","family":"Steinke","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaira S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake T.","family":"Reasoner","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent J.","family":"Alentado","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Department of Neurosurgery, Ascension St. Vincent Hospital, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Porche","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"},{"name":"Department of Neurosurgery, Mayo Clinic, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halle","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin T.","family":"Foley","sequence":"additional","affiliation":[{"name":"Semmes Murphey Neurologic and Spine Institute, Memphis; and"},{"name":"Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A.","family":"Potts","sequence":"additional","affiliation":[{"name":"Goodman Campbell Brain and Spine, Carmel;"},{"name":"Department of Neurosurgery, Ascension St. Vincent Hospital, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"9","key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"931","article-title":"National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999","volume":"28","author":"Angevine PD","year":"2003","unstructured":"Angevine PD, Arons RR, McCormick PC. 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