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Updated: Sep 29, 2025
Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Adopting the day surgery default in the provision of lumbar discectomy and decompressive surgery
Anthony J Paluch1, Alexander H Matthews1, Sophie Mullins1
1The South West Neurosurgery Centre, Derriford Hospital, Plymouth, UK.
Introduction:
Provision of day case spinal procedures in the UK is below expected standards and there is a need for the creation of guidance and patient pathways to address this. Here we present a day case lumbar discectomy protocol and evaluate its impact at our institution.
Methods:
A new pathway (incorporating defined selection criteria, patient education, anaesthetic protocol and discharge prescriptions) was implemented for all suitable patients within a single surgeon's cohort. Day case rates for lumbar discectomy were compared before and after implementation. Patient feedback was collated using a patient-reported experience measure.
Results:
Eighteen of 23 patients selected as suitable via the pathway successfully underwent day surgery, leading to an increase in lumbar discectomy day case rates from 25% to 69% at our institution. Nearly all patients were satisfied with their experience, although a significant proportion felt provision of postoperative analgesia could be improved.
Conclusion:
We present a day surgery pathway for lumbar discectomy that is safe and effective. This could be more widely implemented to increase day case rates.
