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Outcomes After Lumbar Disk Herniation Surgery in the Dutch Population
Maike H J Schepens1, Miranda L van Hooff2,3, Judith A van Erkelens4
1Department Strategy and Quality of Care, Dutch Association of Health Insurers (ZN), Zeist, Netherlands.
Global Spine Journal
|February 12, 2021
Summary
Undesirable outcomes like reoperation and opioid use after lumbar disk herniation (LDH) surgery affect nearly a quarter of Dutch patients. Complication rates vary significantly between hospitals, suggesting a potential benefit from concentrating LDH care.
Area of Science:
- Neurosurgery
- Public Health
- Health Services Research
Background:
- Limited data exists on primary lumbar disk herniation (LDH) surgery outcomes in the Netherlands.
- Understanding patient-relevant undesirable outcomes is crucial for improving surgical care.
Purpose of the Study:
- To describe undesirable outcomes following primary LDH surgery in Dutch patients.
- To identify variations in outcomes across different healthcare providers.
Main Methods:
- Retrospective cohort study using the National Claims Database (Vektis).
- Analysis of primary LDH operations from July 2015 to June 2016.
- Inclusion of reoperations, opioid prescriptions, and nerve root blocks as outcome measures.
Main Results:
- 6895 primary LDH surgeries were analyzed across 70 hospitals.
- Weighted mean outcomes: 7.3% reoperations, 6.7% nerve root blocks, 15.6% opioid use.
- 23.0% of patients experienced at least one undesirable outcome within the follow-up period.
Conclusions:
- A significant proportion of patients undergoing primary LDH surgery experience undesirable outcomes.
- Wide variation in complication rates suggests a potential volume-outcome relationship.
- Concentrating LDH care may lead to improved patient outcomes.
