Outpatient lumbar microdiscectomy: a prospective study in 122 patients.
BACKGROUND
Outpatient surgery saves the risk of nosocomial complications and health care dollars. Patients undergoing lumbar microsurgical discectomy are excellent candidates for outpatient surgery. The object of this study was to examine the feasibility of performing lumbar microdiscectomy on an outpatient protocol and to examine the potential savings associated with such a protocol.


METHODS
From February 1997 to September, 2001, 122 consecutive patients of the senior author were entered into a protocol of outpatient lumbar microdiscectomy. Only elective cases were considered for this study. Patients were excluded if they had significant co-morbidities, lived a significant distance out of town, or if their surgery was scheduled too late in the day. Success was defined as discharge home from the day-surgery unit approximately four hours after surgery.


RESULTS
During the study period, 150 elective lumbar microdiscectomies were performed. Twenty-four patients were excluded based on the above criteria and four patients requested not to participate in the study. Of the remaining 122, 116 successfully completed the protocol (95.1%). Six patients were admitted from the day surgery unit; two patients with dural tears and four patients with anaesthetic side-effects. No patient was readmitted to hospital after discharge and no complications of early discharge were observed. There was a total reduction in hospitalization of 1.2 nights per elective procedure considering the 150 patients, when compared with the hospitalization times prior to outpatient lumbar microdiscectomy.


CONCLUSIONS
Lumbar microdiscectomy can be performed safely as an outpatient procedure, resulting in a substantial reduction in hospitalization times.
Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Ashutosh
A
Singhal
Mark
M
Bernstein
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000191:economics; D017586:Diskectomy / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019990:Perioperative Care; D011446:Prospective Studies; D016896:Treatment Outcome