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Success and safety in outpatient microlumbar discectomy
1Indiana Spine Group, 8402 Harcourt Road, Suite 400, Indianapolis, 46260, USA. nbest@indiana.edu
Abstract:
Currently, many spine surgeons perform microlumbar discectomies on an outpatient basis. Yet, it is often customary for patients to have a 1-night stay in the hospital. Many studies have shown the efficacy of microlumbar discectomy (MLD) and its preference among surgeons for the treatment of lumbar disc herniation. It has also been shown to be safe, successful, and cost-effective. However, a large comprehensive study of this magnitude, gauging safety, success, and patient satisfaction for these procedures on an outpatient basis has not yet been done. One thousand three hundred seventy-seven MLD procedures have been done from 1992 to 2001 by 1 surgeon. A retrospective chart review was done on all procedures. Patients were then contacted by either telephone or mail to complete an outcome questionnaire. Seven hundred thirteen patients (53.9%) completed the questionnaire. Follow-up questionnaires were not completed due to deaths, incorrect contact information, and refused responses. Out of all MLD procedures, 55 (4.0%) were done with a hospital stay-only 24 of these (1.7%) were originally intended outpatient procedures. Of those that were done on an outpatient basis, 8.6% had a complication, including 6.4% who had a recurrent disc herniation. When asked, 81.6% said they would undergo the procedure again as an outpatient. In 82.1% the surgery's outcome was good, very good, or excellent. MLD is a routine procedure that can be performed on an outpatient basis safely, successfully, and with high patient satisfaction.
Insights
Microlumbar discectomy (MLD) is a safe and effective outpatient procedure for lumbar disc herniation. High patient satisfaction and successful outcomes support its routine use, minimizing hospital stays.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Microlumbar discectomy (MLD) is frequently performed for lumbar disc herniation.
- Current practice often includes a 1-night hospital stay, despite MLD's established safety and efficacy.
- A large-scale study evaluating outpatient MLD's safety, success, and patient satisfaction was lacking.
Purpose of the Study:
- To assess the safety, success rates, and patient satisfaction of microlumbar discectomy (MLD) performed on an outpatient basis.
- To determine the feasibility and outcomes of same-day discharge for MLD procedures.
- To provide comprehensive data supporting outpatient MLD as a standard of care.
Main Methods:
- Retrospective chart review of 1,377 MLD procedures performed between 1992 and 2001 by a single surgeon.
- Patient outcomes were assessed via telephone or mail questionnaires.
- Analysis included complication rates, recurrent herniations, and patient-reported satisfaction and outcomes.
Main Results:
- Out of 1,377 MLD procedures, only 4.0% required a hospital stay, with 1.7% initially planned as outpatient.
- For outpatient MLD, complication rates were 8.6%, including 6.4% for recurrent disc herniation.
- 81.6% of patients would repeat the outpatient procedure, and 82.1% reported good to excellent surgical outcomes.
Conclusions:
- Microlumbar discectomy (MLD) can be safely and successfully performed on an outpatient basis.
- High patient satisfaction rates support the routine use of outpatient MLD.
- Outpatient MLD offers a safe, effective, and satisfying treatment option for lumbar disc herniation.
