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Predicting patient outcomes after far lateral lumbar discectomy
Eric Winter1, Donald K Detchou1, Gregory Glauser1
1Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Clinical Neurology and Neurosurgery
|March 8, 2021
Summary
The LACE+ index effectively predicts adverse outcomes like readmission and reoperation after spine surgery for far lateral disc herniation. This tool can help characterize perioperative risks in this patient population.
Area of Science:
- Neurosurgery
- Spine Surgery
- Health Services Research
Background:
- The LACE+ index (Length of Stay, Acuity of Admission, Charlson Comorbidity Index, Emergency Department visits) has not been validated in spine surgery patients.
- Far lateral disc herniation (FLDH) surgery carries risks of adverse perioperative events.
Purpose of the Study:
- To assess the predictive ability of the LACE+ index for adverse outcomes in patients undergoing discectomy for FLDH.
- To determine if LACE+ can identify patients at higher risk for complications.
Main Methods:
- Retrospective analysis of 144 patients who underwent far lateral lumbar discectomy (2013-2020).
- LACE+ scores calculated for 100 patients; logistic regression used to predict readmission, ED visits, and reoperation.
- Confounding variables were controlled using stepwise regression.
Main Results:
- Each LACE+ score increase predicted higher risk of 30-day and 30-90-day readmission and ED visits.
- Increasing LACE+ scores also predicted reoperation and repeat neurosurgical intervention within 30 and 90 days post-discharge.
- LACE+ score predicted reoperation within 30 days of initial surgery.
Conclusions:
- The LACE+ index demonstrates suitability for risk stratification in patients undergoing far lateral discectomy.
- LACE+ can help characterize perioperative risks and guide management for FLDH patients.
