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Day case lumbar discectomy--viable option in the UK?
Ahmed Abou-Zeid1, James Palmer, Kanna Gnanalingham
1Department of Neurosurgery, Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust , Manchester , UK.
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.
