Ambulatory microsurgery for ruptured lumbar discs: report of ten cases

Advances in microsurgical techniques combined with a widening interest in same-day surgery led us to investigate ambulatory lumbar discectomy. We could find no precedent in the literature. Ten patients with classic ruptured lumbar discs confirmed by computed tomography chose to participate. They were aged 31 to 51, seven men and three women, in excellent general health. A microsurgical approach through a 25-mm skin incision was performed. The technique emphasized removal of sufficient medial facet to allow excision of the disc with minimal or no root retraction. Once awake in the recovery room, patients were transferred to a separate ambulatory step-down unit. They were discharged only after they had voided, ambulated, taken oral nourishment, and been examined by the surgeon. A visiting nurse checked the patient at home the evening of operation and the next day. All returned to their usual occupation between 3 and 14 days postoperatively. All were satisfied and would choose the outpatient program again. Our experience indicates that ambulatory lumbar microdiscectomy can be a safe, effective option for selected patients.