Time spent per patient in lumbar spinal stenosis surgery

Abstract

Purpose To examine the time needed from a surgeon's viewpoint to treat a patient operated for lumbar spinal stenosis. We firstly aimed to give evidence of the wide ranging duration of standardized procedure. Secondly, we investigated factors affecting the time allocated to each patient. Methods 438 medical records of patients operated on for lumbar decompression without fusion (2005)(2006)(2007)(2008)(2009)(2010)(2011) were retrospectively examined. Primary data were operative time (OT, min), length of stay (LoS, days) and number of postoperative visits. A fourth parameter was calculated, the time spent per patient (TSPP, min) by summing the time spent in surgery, during inpatient and outpatient follow-up visits. Factors that influenced these medical resources were examined. Results Median (5th-95th percentile) LoS was 5 days (2-15), , number of medical visits 5 (2-11) and TSPP 329 min (206-533). In descending order, factors predicting LoS were age, no. of levels, sex, operative technique, cardiovascular risk index, dural tear and haematoma. Factors predicting OT were number of levels, dural tear, foraminotomy, synovial cyst and body mass index. The statistical model could predict 36 % of the TSPP variance. We recommend that surgeons add 35 min for each level, 29 min for patients over 65 years, 30 min for women, 132 min for dural tear and 108 min for epidural haematoma.Conclusion TSPP treated for lumbar spinal stenosis is highly variable, yet partially predictable. These data may help individual surgeons or heads of departments to plan their activities.

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Prä- und postoperative Fast-track-Behandlungskonzepte in der Wirbelsäulenchirurgie

“…ches Geschlecht, Patienten über 65 Jahre[10]. Demgegenüber stellen Jörgen-sen et al[9] eine Studie vor, die im Rahmen von Fast-track-Versorgen an Knieund Hüften zeigt, dass selbst bei alten Patienten mit Komorbiditäten eine Reduzierung der Krankenhausbehandlungsdauer erzielt werden kann.Die patientenbezogenen Faktoren stellen jedoch nur einen Teil der Einflüsse auf ein optimiertes Entlassungsmanagement dar.…”

Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome

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