Clinical and health economic benefits of out-patient lumbar microdiscectomies in Australia.

Publications

Share / Export Citation / Email / Print / Text size:

Australasian Journal of Neuroscience

Australian Association of Neuroscience Nursing

Subject: Nursing

GET ALERTS

ISSN: 1032-335X
eISSN: 2208-6781

DESCRIPTION

25
Reader(s)
82
Visit(s)
0
Comment(s)
0
Share(s)

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue / page

Archive
Volume 30 (2020)
Volume 29 (2019)
Volume 28 (2018)
Volume 27 (2017)
Volume 26 (2016)
Volume 25 (2015)
Related articles

VOLUME 26 , ISSUE 2 (October 2016) > List of articles

Clinical and health economic benefits of out-patient lumbar microdiscectomies in Australia.

Alison Magee * / Ivan P Bhaskar / Paul Ilett / Michael A Murphy / Yi-Yuen Wang

Keywords : Microdiscectomy, outpatient, economic

Citation Information : Australasian Journal of Neuroscience. Volume 26, Issue 2, Pages 0-0, DOI: https://doi.org/10.21307/ajon-2017-129

License : (CC BY-NC-ND 4.0)

Published Online: 25-January-2018

ARTICLE

ABSTRACT

Introduction: This study reports on the clinical, nursing and health outcomes on the out-patient lumbar microdiscectomy program at a single institution. A multi-disciplinary team approach to the pre- and post-operative planning and education is key to the success of this program.


Methods: A retrospective review of prospectively collected data for two patient groups (outpatient microdiscectomy and in-patient microdiscectomy) over a two-year period in a single institution was performed. Clinical, demographical, surgical and economic measures were collected including a 10-point visual analogue pain scale (VAS), patient satisfaction, direct and indirect costs of treatment. Patients included had a single level lumbar disc prolapse with persistent disabling sciatica of more than 8 weeks consistent with failure of conservative measures.


Results: Twenty-one out-patient and forty-one in-patient microdiscectomy patients were treated over this period. Post operatively pain levels showed a significant improvement in VAS levels from 5.2 ±2.9 to 1.6 ±0.8 and 0.7 ± 0.8 at day 1 and 7 post-operatively respectively. This was not different across both groups. Patient satisfaction was high in both surgical groups. There was a significant cost savings in out-patient lumbar micro-discectomy with the majority of savings coming from costs associated with staff (nursing, allied health and medical) funding. There was successful discharge 100% of out-patient microdiscectomy patients without readmission.


Conclusion: Outpatient lumbar microdiscectomy is a viable option in Australia. It demonstrates no difference in patient outcomes as compared to in-patient lumbar microdiscectomies and has high patient satisfaction outcomes. There are significant benefits in terms of health economics and nursing care in establishing an out-patient lumbar microdiscetomy program.

Content not available PDF Share

FIGURES & TABLES

REFERENCES

  1. Abou-Zeid A, Palmer J, Gnanalingham K. (2014) Day case lumbar discectomy – Viable option in the UK? Journal of Neurosurgery, 28(3), 320-323. doi 10.3109/02688697.2013.848839.
  2. Aichmair A, Du JY, Shue J, Evangelisti G, Sama AA, Hughes AP, Isbl DR, Burket JC, Cammisa FP, Giradi FP (2014). Microdiscectomy for treatment of lumbar disc herniation: an evauluation of reoperations and long-term outcomes. Evid
    Based Spine Care, 5 (2), 77-86.doi:10.1055ls-0034-186750
  3. Bookwalter JW 3rd, Busch MD, Nicely D. (1994) Ambulatory surgery is safe and effective in radiculardisc disease. Spine (Phila Pa 1976), 19 (5), 526-530
  4. Danielsen JM, Johnsen R, Kibsgaard SK, Hellevik E.(2000) Early aggressive exercise for postoperative rehabilitation after discectomy. Spine (Phila Pa 1976), 25(8), 1015-1020.
  5. Dolan P, Greenfield K, Nelson RJ, Nelson IW. (2000) Can exercise therapy improve the outcome of microdisectomy? Spine, 25 (12), 1523-1532.
  6. Gonzalez-Castro A, Shetty A, Nagendar K, Greenough CG.(2002) Day-case conventional discectomy:a randomized controlled trial. European Spine Journal, 11, 67-70.
  7. Koebbe CJ, Maroon JC, Abla A, El-Kadi H, Bost J.(2002) Lumbar microdisectomy: a historical perspective and current technical considerations. Neurosurgical Focus, 13(2), E3
  8. Kreiner DS, Hwang SW, Easa JE, REsnick DK, Baisden JL, Bess S, Cho CH, DePalma MJ, Dougherty P2nd, Fernand R, Ghiselli G, Hanna AS, Lamer T, Lisi AJ, Mazanec DJ, Meagher RJ, Nucci RC, Sembrano JN, Sharma AK, Summers
    JT, Taleghani CK, Tontz WL Jr, Toton JF (2014) An evidence- based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine Journal, 14 (1),180-191.
  9. Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes SA.(2013) Outpatient surgery reduces short-term complications in lumbar discectomy: an analysis of 4310 patients from the ACS-NSQIP database. Spine Journal (Phila Pa 1976), 38(3),264-271. doi:10.1097/BRS.0b013e3182697b57.
    [CROSSREF]
  10. Singhal A, Bernstein M. (2002) Outpatient lumbar micro discectomy: A prospective study in 122 patients. Canadian Journal Neurology Sciences,29, 249-252.
  11. Soliman J, Harvey A, Howes G, Seibly J, Dossey J,Nardone E. (2014). Limited microdiscectomy for lumbar disk herniation: a retrospective longterm outcome analysis. Journal of Spinal,Disorders and Techniques 27(1), E8-13.
    doi:10.1097/BSD.Ob013e31828da8f1.

EXTRA FILES

COMMENTS