203-patient analysis at DISC Surgery Centers shows 100% discharge within 23 hours with up to 60% lower total episode-of-care costs compared with hospital-based fusion procedures
NEWPORT BEACH, Calif., Dec. 5, 2025 /PRNewswire/ — A new study led by orthopedic spine surgeon Steven J. Girdler, MD, of DISC Surgery Center, shows that even the most complex spinal fusions—anterior-posterior lumbar interbody fusions (ALIF + PSF, also known as 360° fusions)—can be performed safely and effectively in an outpatient setting, achieving substantial cost savings for payers and improved recovery for patients.
The retrospective analysis evaluated 203 consecutive outpatient 360° fusions performed between 2018 and 2024 at a single ambulatory surgery center. All 203 patients were discharged within 23 hours, meeting the definition of same-day surgery. No hospital transfers, blood transfusions, or readmissions occurred in the immediate perioperative period. The average operating time was 167 minutes, and all patients began recovery at home within a day of surgery. Read the abstract HERE.
“These are highly complex procedures that once required three or four days in the hospital,” said Dr. Girdler. “To safely complete a 360° fusion as a single, minimally invasive episode of care and discharge patients within 23 hours is a major step forward for both patient outcomes and the healthcare system.”
Hospital–based lumbar fusion surgeries have long ranked among the most costly surgical procedures in spine care. National data show more than 455,000 inpatient spinal–fusion admissions in 2018 with total hospital costs exceeding $14.1 billion. Among these, roughly 40,000 represent circumferential (360°) fusions. Previous research has shown that outpatient same-day fusion (ALIF) can reduce total episode-of-care costs by 50 to 70% compared to inpatient procedures. Migration of even 50% of appropriate cases to the outpatient setting would generate approximately $800 million to $1.2 billion in annual savings for payers and health systems, while offering patients faster recovery and reduced exposure to hospital-acquired complications.
Beyond cost, the outpatient model confers clear patient and provider advantages, including reduced infection risk, faster return to activity, and improved comfort of home recovery. These benefits, Dr. Girdler emphasizes, are achievable only in centers designed specifically to support complex, minimally invasive spine procedures.
“Our model shows that outpatient fusion can achieve excellent patient outcomes while dramatically lowering total cost of care—but it’s only possible when a surgery center has the right infrastructure and team in place,” Dr. Girdler added.
DISC Surgery Center’s parent company, TriasMD, attributes this success to a model built on four integrated pillars: experienced surgical teams skilled in minimally invasive technique; customized perioperative protocols tailored for higher-acuity outpatient care; purpose-built facilities featuring larger ORs, private recovery suites, and advanced infection-control systems; and comprehensive patient education to engage patients and families at every stage of recovery.
“The implications extend far beyond one center,” said Rojeh Melikian, MD, a spine surgeon within the Trias Global network. “When these outcomes are replicated across our clinically integrated network, the result is a safer, more efficient, and more patient-centered model of spine care that benefits everyone—patients, physicians, and payers alike.”
TriasMD’s clinically integrated network, Trias Global, has tracked these outcomes across several spine surgeons, including Joel S. Beckett, MD, Robert S. Bray, Jr., MD, FAANS, Steven J. Girdler, MD, Brandon Hirsch, MD, Nick Jain, MD, Amer Khalil, MD, Luke Macyszyn, MD, FAANS, FACS, Rojeh Melikian, MD, Ali H. Mesiwala, MD, FAANS and Grant D. Shifflett, MD.
The study results underscore an accelerating national trend: as technology, expertise, and infrastructure evolve, procedures once limited to hospitals are moving successfully into advanced outpatient settings, improving patient satisfaction while substantially lowering healthcare costs.
About the DISC Surgery Centers
The DISC Surgery Centers are known for high-quality, minimally invasive spine surgery, interventional pain management, orthopedics and sports medicine. Each state-of-the-art facility is focused on patient satisfaction, with top physicians delivering care in a safe, inviting setting. With locations throughout California, these exceptional surgery centers are part of Trias Global, a clinically integrated network of healthcare providers built and managed by DISC parent company, TriasMD, a Chicago Pacific Founders portfolio company. For more information, call 949-988-7800, visit www.discmd.com or follow @DISCMD.
About Trias Global
Part of TriasMD, Trias Global is a clinically integrated network of highly specialized spine and musculoskeletal ambulatory surgery centers (ASCs) partnered with primary care physicians, laboratories and imaging organizations. TriasMD positions these facilities to thrive by carefully selecting healthcare providers with demonstrated expertise and performance; investing in leading-edge technologies and infrastructure; collaborating with insurers and healthcare institutions; and standardizing quality assurance for complex outpatient procedures through business intelligence and analytics. As a result, all Trias Global ASCs deliver superior care and experiences while reducing costs for patients, providers and payers alike. For more information, visit www.triasmd.com.
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SOURCE DISC Surgery Center
