Correlation Between Health Outcome and Length of Hospital Stay in Lumbar Microdiscectomy

Lorish, Thomas R.; Tanabe, Calvin T.; Waller, Frederick T.; London, Marla R.; Lansky, David

doi:10.1097/00007632-199810150-00010

Cited by 29 publications

(23 citation statements)

References 10 publications

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“…Such differences may have different implications when analyzed from the perspective of the patient, surgeon, hospital, or insurance provider. Lorish et al 9 have suggested that, from the perspective of the insurance provider, the cost savings of a 1-day versus a 2-day hospitalization after lumbar discectomy is ~ $781. A prospective, randomized clinical trial has been proposed to specifically address the issue of costeffectiveness.…”

Section: Effect Of a Minimally Invasive Approach On Perioperative Outmentioning

confidence: 99%

Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy

German

Adamo

Hoppenot

et al. 2008

FOC

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Object Minimally invasive lumbar discectomy is a refinement of the standard open microsurgical discectomy technique. Proponents of the minimally invasive technique suggest that it improves patient outcome, shortens hospital stay, and decreases hospital costs. Despite these claims there is little support in the literature to justify the adoption of minimally invasive discectomy over standard open microsurgical discectomy. In the present study, the authors address some of these issues by comparing the short-term outcomes in patients who underwent first time, single-level lumbar discectomy at L3–4, L4–5, or L5–S1 using either a minimally invasive percutaneous, muscle splitting approach or a standard, open, muscle-stripping microsurgical approach. Methods A retrospective chart review of 172 patients who had undergone a first-time, single-level lumbar discectomy at either L3–4, L4–5, or L5–S1 was performed. Perioperative results were assessed by comparing the following parameters between patients who had undergone minimally invasive discectomy and those who received standard open microsurgical discectomy: length of stay, operative time, estimated blood loss, rate of cerebrospinal fluid leak, post-anesthesia care unit narcotic use, need for a physical therapy consultation, and need for admission to the hospital. Results Forty-nine patients underwent minimally invasive discectomy, and 123 patients underwent open microsurgical discectomy. At baseline the groups did differ significantly with respect to age, but did not differ with respect to height, weight, sex, body mass index, level of radiculopathy, side of radiculopathy, insurance status, or type of preoperative analgesic use. No statistically significant differences were identified in operative time, rate of cerebrospinal fluid leak, or need for a physical therapy consultation. Statistically significant differences were identified in length of stay, estimated blood loss, postanesthesia care unit narcotic use, and need for admission to the hospital. Conclusions In this retrospective study, patients who underwent minimally invasive discectomy were found to have similiar perioperative results as those who underwent open microsurgical discectomy. The differences, although statistically significant, are of modest clinical significance.

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Section: Effect Of a Minimally Invasive Approach On Perioperative Outmentioning

confidence: 99%

Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy

German

Adamo

Hoppenot

et al. 2008

FOC

View full text Add to dashboard Cite

show abstract

“…This perspective allows us to see that the results are the product of the disease motivating the patient's admission, without influence of other factors such as co-morbidity and orthopedic morbidity, or, as expected from the preceding publications [26], age. There are several references about populations of other countries that use the SF-36 in the same way in patients with lumbar disease, i.e., standardizing by age and gender [12,35,39,53]; this is not so in Spain, where our study is the first to compare these four groups of diseases using the T scores of the SF-36.…”

Section: Discussionmentioning

confidence: 99%

“…In any case, when we adjust the results for age and gender (an adjustment not made in previous studies), statistically significant differences in quality of life begin to emerge in patients with lumbar disease as compared to the other groups [4,19,28,35,42].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

et al. 2012

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Introduction Despite the high prevalence of musculoskeletal diseases, in Spain there are few data about how these conditions affect the quality of life of individuals. The objective of this study was to assess the quality of life (QOL) of patients candidate for orthopedic surgical treatment using an age-gender adjusted method of QOL scores. Materials and methods The SF-36 Health Survey was administered to 538 patients candidate for surgery between surgical treatment was classified in four groups (lumbar disease, cervical disease, knee arthroplasty, and hip arthroplasty). Associated morbidities were collected retrospectively for all cases using the Charlson co-morbidity index. Univariate, bivariate, and multivariate statistical analyses were done to compare the four groups to each other, to the general population mean, and to the age and gender-adjusted population mean. Results 234 men and 304 women whose mean age was 58.78 years (19-89) were assessed. Patients candidate for some kind or lumbar surgery had the worst scores in all physical and mental scales as compared to the other disease groups. Patients candidate for knee arthroplasty, had the best quality of life scores in all scales, compared to the other disease groups. Medical conditions had no influence over the summary measures. Conclusion Presenting the results of SF-36 in standard deviations from the age-and gender-adjusted population mean (T values) leads to a better appreciation of the differences between the various diseases. Patients candidate for surgery of the lumbar spine had a worse QOL, while the QOL in patients candidate for knee arthroplasty was the least affected.

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“…Patients reporting improvement after surgery reached higher the PCS score and the MCS score. On the other hand, the fact of not taking analgesics has been connected only with the MCS [22,23]. The dependence appears interesting in that it is not the physical condition, yet the psychological one that is decisive for taking analgesics.…”

Section: Discussionmentioning

confidence: 99%

Quality of life and sociodemographic data in patients after spine surgery

2012

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Correlation Between Health Outcome and Length of Hospital Stay in Lumbar Microdiscectomy

Cited by 29 publications

References 10 publications

Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy

Perioperative results following lumbar discectomy: comparison of minimally invasive discectomy and standard microdiscectomy

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

Quality of life and sociodemographic data in patients after spine surgery

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