Degenerative cervical myelopathy (DCM) is the most common cause of acquired nontraumatic spinal cord dysfunction in adults [1,2]. The worldwide prevalence of DCM is continuing to increase, largely due to aging populations [3]. Prior economic evaluations have demonstrated that decompression and fusion surgery for DCM is cost-effective from the health care payer perspective [4–6]. Current evidence also suggests that surgery is associated with improved quality of life and neurological function for DCM patients with moderate and severe myelopathy as graded using the Modified Japanese Orthopedic Association (mJOA) scale [7].

Although outpatient spine surgery is becoming increasingly popular in the United States, unplanned readmission following outpatient surgery remains a significant postoperative concern.

Anterior cervical discectomy and fusion (ACDF) is a commonly-performed and generally well-tolerated procedure used to treat cervical disc herniation. Rarely, patients require discharge to inpatient rehab, leading to inconvenience for the patient and increased healthcare expenditure for the medical system.

Prior study has shown that 70% of cervical pseudarthrosis after anterior cervical discectomy and fusion (ACDF) detected at 1 year will go on to fusion by 2 year. Pseudarthrosis detected 2 years after ACDF may have different bone healing potential compared to nonunion detected 1 year after surgery. Therefore, it might have a different clinical significance.

Spinal cord injury (SCI) is a global health problem with a heavy economic burden. Surgery is considered as the cornerstone of SCI treatment. Although various organizations have formulated different guidelines on surgical treatment for SCI, the methodological quality of these guidelines has still not been critically appraised.