Trends in outpatient minimally invasive spine surgery.

There has been a definite upward trend in outpatient minimally invasive spine (MIS) surgery over the past decade. This increasing prevalence has been driven by several factors including advanced MIS techniques, improvements in perioperative pain management, and economic necessity. There is now a myriad of different spine surgery procedures which can be effectively employed in the outpatient setting, and the concept of awake, endoscopic fusion surgery represents a notable advance in the field. Additionally, the use of multi-modality analgesic agents has shown significant promise in this arena and has become increasingly important in states where legislation affecting narcotic prescriptions have been enacted. Finally, with an aging population, the need for outpatient spine surgery has become imperative from an economic standpoint.