Outpatient Cervical and Lumbar Spine Surgery is Feasible and Safe: A Consecutive Single Center Series of 1449 Patients.

Abstract

BACKGROUND:

There is an increasing demand for surgery of degenerative spinal disease. Limited healthcare resources draw attention to the need for cost-effective treatments. Outpatient surgery, when safe and feasible, is more cost effective than inpatient surgery.

OBJECTIVE:

To study types and rates of complications after outpatient lumbar and cervical spine decompressions.

METHODS:

Complications were recorded prospectively in 1449 (1073 lumbar, 376 cervical) outpatients undergoing microsurgical decompression for degenerative spinal disease at the private Oslofjord Clinic from 2008 to 2013.

RESULTS:

Surgical mortality was 0%. A total of 51 (3.5%) minor and major complications were recorded in 51 patients. Three (0.2%) patients had to be admitted to a hospital the day of surgery. Twenty-two (1.5%) patients were admitted to a hospital within 3 months due to surgery-related events. The encountered complications were postoperative hematoma (0.6%), neurological deterioration (0.3%), deep wound infection (0.9%), dural lesions with cerebrospinal fluid leakage (1.0%), persistent dysphagia (0.1%), persistent hoarseness (0.1%), and severe pain/headache (0.4%). All of the life-threatening hematomas were detected within 6 and 3 hours after cervical and lumbar surgery, respectively.

CONCLUSION:

This series of 1449 consecutive outpatient microsurgical spine decompressions adds to the growing literature in favor of outpatient spinal surgery in properly selected patients. In our study, 99.8% of the patients were successfully discharged either to their homes or to a hotel on the day of surgery. The overall complication rate was 3.5%, surgical mortality was 0%, and only 1.5% had to be admitted to a hospital within 3 months after surgery.

• Authors: Øystein Helseth, Bjarne Lied, Charlotte Marie Halvorsen, Kåre Ekseth, Eirik Helseth
• Journal: Neurosurgery (Neurosurgery) Vol. 76 Issue 6 Pg. 728-37; discussion 737-8 (Jun 2015) ISSN: 1524-4040 [Electronic] United States
• PMID: 25853437 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Ambulatory Surgical Procedures (adverse effects)
• Decompression, Surgical (methods)
• Feasibility Studies
• Female
• Humans
• Intervertebral Disc Degeneration (surgery)
• Male
• Microsurgery
• Middle Aged
• Neurosurgical Procedures (adverse effects, methods)
• Postoperative Complications (epidemiology, etiology)
• Young Adult