In this era of escalating health care costs and increasingly limited health care resources, there has been increased interest in restraining health care costs and maximizing the benefit of each dollar spent. It has been estimated that the direct medical costs of the over 200,000 lumbar discectomies performed annually in the United States, exceeds $5 billion US. [1][2][3] There has been an explosive growth in the field of costeffectiveness analysis. There is now an increasing body of literature dealing specifically with the cost-effectiveness of lumbar discectomy for the treatment of herniated intervertebral discs. 2,4,5 These studies suggest that the incremental (that is, above the cost of continued conservative management) cost of lumbar discectomy, is between $5,200 and $12,500 US including ABSTRACT: Background: Outpatient surgery saves the risk of nosocomial complications and health care dollars. Patients undergoing lumbar microsurgical discectomy are excellent candidates for outpatient surgery. The object of this study was to examine the feasibility of performing lumbar microdiscectomy on an outpatient protocol and to examine the potential savings associated with such a protocol. Methods: From February 1997 to September, 2001, 122 consecutive patients of the senior author were entered into a protocol of outpatient lumbar microdiscectomy. Only elective cases were considered for this study. Patients were excluded if they had significant co-morbidities, lived a significant distance out of town, or if their surgery was scheduled too late in the day. Success was defined as discharge home from the day-surgery unit approximately four hours after surgery. Results: During the study period, 150 elective lumbar microdiscectomies were performed. Twenty-four patients were excluded based on the above criteria and four patients requested not to participate in the study. Of the remaining 122, 116 successfully completed the protocol (95.1%). Six patients were admitted from the day surgery unit; two patients with dural tears and four patients with anaesthetic side-effects. No patient was readmitted to hospital after discharge and no complications of early discharge were observed. There was a total reduction in hospitalization of 1.2 nights per elective procedure considering the 150 patients, when compared with the hospitalization times prior to outpatient lumbar microdiscectomy. Conclusions: Lumbar microdiscectomy can be performed safely as an outpatient procedure, resulting in a substantial reduction in hospitalization times.RÉSUMÉ: La microdiscectomie lombaire ambulatoire: étude prospective de 122 patients. Introduction: La chirurgie ambulatoire diminue le risque de complications opportunistes et les coûts de santé. Les patients qui subissent une discectomie lombaire par microchirurgie sont d'excellents candidats à la chirurgie ambulatoire. Le but de cette étude était d'examiner la faisabilité d'un protocole de microdiscectomie lombaire effectuée en externe et la diminution des coûts associés. Méthodes: 122 patients consécu...