title: Time spent per patient in lumbar spinal stenosis surgery.
abstract: OBJECTIVE
  To examine the time needed from a surgeon's viewpoint to treat a patient operated for lumbar spinal stenosis. We firstly aimed to give evidence of the wide ranging duration of standardized procedure. Secondly, we investigated factors affecting the time allocated to each patient.
  
  
  METHODS
  438 medical records of patients operated on for lumbar decompression without fusion (2005-2011) were retrospectively examined. Primary data were operative time (OT, min), length of stay (LoS, days) and number of postoperative visits. A fourth parameter was calculated, the time spent per patient (TSPP, min) by summing the time spent in surgery, during inpatient and outpatient follow-up visits. Factors that influenced these medical resources were examined.
  
  
  RESULTS
  Median (5th-95th percentile) LoS was 5 days (2-15), OT 106 min (60-194), number of medical visits 5 (2-11) and TSPP 329 min (206-533). In descending order, factors predicting LoS were age, no. of levels, sex, operative technique, cardiovascular risk index, dural tear and haematoma. Factors predicting OT were number of levels, dural tear, foraminotomy, synovial cyst and body mass index. The statistical model could predict 36% of the TSPP variance. We recommend that surgeons add 35 min for each level, 29 min for patients over 65 years, 30 min for women, 132 min for dural tear and 108 min for epidural haematoma.
  
  
  CONCLUSIONS
  TSPP treated for lumbar spinal stenosis is highly variable, yet partially predictable. These data may help individual surgeons or heads of departments to plan their activities.
authors: Department of orthopaedicsurgery, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200 Brussels, Belgium. kaminski.ludovic@gmail.com
authors: Ludovic
authors: L
authors: Kaminski
authors: Xavier
authors: X
authors: Banse
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D019637:Orthopedic Procedures; D011182:Postoperative Care; D012189:Retrospective Studies; D012737:Sex Factors; D013130:Spinal Stenosis / Q000601:surgery*
references: Spine J. 2011 Jul;11(7):613-7
references: 21482198
references: Spine (Phila Pa 1976). 2002 Apr 15;27(8):818-24
references: 11935103
references: Eur Spine J. 2012 May;21(5):825-8
references: 22146791
references: J Am Geriatr Soc. 1996 Mar;44(3):285-90
references: 8600197
references: Circulation. 1999 Sep 7;100(10):1043-9
references: 10477528
references: N Engl J Med. 2008 Feb 21;358(8):794-810
references: 18287602
references: Spine J. 2009 Jul;9(7):545-50
references: 19398386
references: J Neurosurg Spine. 2008 Dec;9(6):554-9
references: 19035747
references: Spine J. 2011 Aug;11(8):705-11
references: 21641874
references: J Bone Joint Surg Am. 1997 Oct;79(10):1481-8
references: 9378733
references: Spine (Phila Pa 1976). 2008 May 15;33(11):1250-5
references: 18469700
references: Anesthesiology. 1978 Oct;49(4):233-6
references: 697075
references: Clin Orthop Relat Res. 2012 May;470(5):1436-41
references: 22402810
references: Neurosurgery. 2011 Jul;69(1):38-44; discussion 44
references: 21358354
references: Spine (Phila Pa 1976). 2008 Nov 15;33(24):2651-61; discussion 2662
references: 18981957
references: J Neurosurg Spine. 2012 Feb;16(2):135-40
references: 22054639
references: J Neurosurg Spine. 2005 Aug;3(2):129-41
references: 16370302
references: Clin J Pain. 2012 Jun;28(5):382-6
references: 22001665
references: Eur Spine J. 2012 Dec;21(12):2693-703
references: 22661202
references: J Neurosurg Spine. 2009 Apr;10(4):293-9
references: 19441985
references: J Neurosurg Spine. 2012 Jan;16(1):68-76
references: 21961964
references: Ger Med Sci. 2012;10:Doc08
references: 22557941
references: Neurosurgery. 2002 Nov;51(5 Suppl):S146-54
references: 12234442
references: Spine (Phila Pa 1976). 2006 Jan 1;31(1):99-103
references: 16395185
references: Indian Heart J. 2012 Mar-Apr;64(2):134-8
references: 22572486
references: Eur Spine J. 2007 Dec;16(12):2133-42
references: 17712577
references: JAMA. 2010 Apr 7;303(13):1259-65
references: 20371784
references: Clin Orthop Relat Res. 2006 Feb;443:139-46
references: 16462438
references: Spine (Phila Pa 1976). 2008 Mar 1;33(5):514-8
references: 18317196
references: Eur Spine J. 2012 Mar;21(3):411-7
references: 21915746