Can Spine Surgery Be Done as an Outpatient Procedure at a University Health Sciences Centre?

At our centre, discectomies and laminectomies were traditionally done as inpatient surgery. A gradual change in practice was instituted between 2010 and 2014 to try to do these procedures as outpatient surgery. In comparing two 12-month periods, one before implementation and the other after, we found a change in the number of outpatient discectomies from 0 to 47 and laminectomies from 0 to 17. The change was received positively, as evidenced by an increase in total (inpatient and outpatient) discectomies from 54 to 63, laminectomies from 22 to 54 and patients from outside of our LHIN increased from 22 to 28%.(Ontario is divided into 14 regions with healthcare services in each planned, funded, and managed through a Local Health Integration Network.) It was efficacious with no hospital readmissions within 30 days and no change in the rate of patients' self-reported improvement postoperatively. Our findings are consistent with the reports of others that outpatient discectomy is safe and effective with resultant cost savings to the healthcare system. Our early results suggest that some outpatient laminectomies are also possible.