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

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• The inpatient length of stay for lumbar discectomy has decreased significantly over time.
• Day case lumbar discectomy was first described in 1987 but has seen limited adoption.
• This study details the initial implementation of day case lumbar discectomy in Manchester.

Purpose of the Study:

• To evaluate the feasibility and safety of day case lumbar microdiscectomy.
• To assess patient outcomes and identify factors influencing discharge disposition.
• To explore the economic benefits of day case procedures.

Main Methods:

• A 2-year prospective study included 50 patients meeting day case surgery criteria.
• Standard microscopic techniques were employed for lumbar discectomy.
• Patients were admitted and discharged via a dedicated day case unit.

Main Results:

• 72% of patients (36/50) were discharged home the same day after single-level, unilateral discectomies.
• 28% (14/50) were discharged within 24 hours, citing back pain or hypotension.
• Significant improvement in back and leg pain was reported by 94% (47/50) of patients (p < 0.01).

Conclusions:

• Day case lumbar microdiscectomy is a viable and safe surgical option for carefully selected patients.
• This approach can contribute to efficient inpatient bed utilization.
• The procedure offers considerable economic advantages and positive patient outcomes.