Day case lumbar discectomy--viable option in the UK?

Br J Neurosurg. 2014 Jun;28(3):320-3. doi: 10.3109/02688697.2013.848839. Epub 2013 Oct 21.

Abstract

Introduction: The inpatient length of stay for lumbar discectomy has been steadily declining, since its original description over 80 years ago. The operation was first described as a day case procedure in 1987, but only sporadically since then, especially in the UK. We describe our initial experience in introducing this service in Manchester.

Methods: Over a 2-year period, 50 of 80 patients undergoing lumbar discectomy met the inclusion criteria for day case surgery, using standard microscopic techniques and admission via a day case unit.

Results: Majority (N = 48) were single level, unilateral discectomies and 36 (72%) were discharged home the same day. The remainder (28%) were discharged after an overnight stay and within 24 h. Reasons for this included post-operative back pain and hypotension. Majority (N = 47), reported improvement or resolution of pre-operative back and leg pain, which was quantified using Visual analogue scores (p < 0.01).

Conclusions: Lumbar microdiscectomy as a day case procedure remains a feasible and safe option in selected patients and can help free up in patient beds with a significant economic benefit also.

Keywords: day case surgery; lumbar discectomy.

MeSH terms

  • Adult
  • Aged
  • Ambulatory Surgical Procedures / methods*
  • Ambulatory Surgical Procedures / trends*
  • Back Pain / surgery
  • Diskectomy / methods*
  • Female
  • Humans
  • Intervertebral Disc Displacement
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Pain / surgery
  • Pain Measurement
  • Postoperative Care
  • Postoperative Complications / epidemiology
  • Treatment Outcome
  • United Kingdom
  • Young Adult