Literature DB >> 22274783

Preliminary results on feasibility of outpatient instrumented transforaminal lumbar interbody fusion.

Alan T Villavicencio1, Ewell Lee Nelson, Alexander Mason, Sharad Rajpal, Sigita Burneikiene.   

Abstract

STUDY
DESIGN: A retrospective chart review study was performed.
OBJECTIVE: The primary objective of this study was to analyze our preliminary results to examine whether it is safe and effective to perform instrumented lumbar interbody fusions on an outpatient basis by comparing 2 groups of patients who were discharged the same day versus those who stayed overnight. The secondary objective was to identify the need for prolonged observation for complications that may occur in the immediate postoperative period. SUMMARY OF BACKGROUND DATA: There is currently no information in the literature on the safety and complication rates of instrumented transforaminal lumbar interbody fusions performed in an ambulatory surgery setting.
METHODS: Surgeries were performed at an ambulatory surgery center (n=27) or hospital outpatient departments (n=25). The mean age of patients was 49.8 years (range, 19-72 y). The safety of outpatient lumbar fusions was assessed by analyzing complications that occurred from the moment of discharge up to the seventh postoperative day (0-7 POD), as well as all complications that occurred up to 6 months postoperatively (>7 POD). The efficacy of surgical intervention was also evaluated by assessing change in pain, patient satisfaction scores, and fusion rates.
RESULTS: There were no cases of pneumonia, urinary tract infection, or thromboembolic complications. Four patients (14%) who had surgeries performed at an ambulatory surgery center had complications within 7 days postoperatively compared with 1 (4%) patient who had surgery performed at a hospital outpatient department. This difference was not statistically significant (P=0.36, Fisher exact test). Lower back and leg pain was significantly (P<0.0001) decreased postoperatively. The average postoperative back pain was 18.8 (range, 0-90) compared with 74.5 (range, 0-100) preoperatively as measured on a 0-100 visual analog scale. The average postoperative leg pain was 9.1 (range, 0-60) compared with 54.2 (range, 0-100) preoperatively.
CONCLUSIONS: Although further confirmation is needed, this study discusses the possibility of performing instrumented lumbar interbody fusions with the transforaminal lumbar interbody fusion technique as an outpatient procedure. These results support a future prospective randomized study with a well-defined patient selection criteria.

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Year:  2013        PMID: 22274783     DOI: 10.1097/BSD.0b013e318246aea2

Source DB:  PubMed          Journal:  J Spinal Disord Tech        ISSN: 1536-0652


  10 in total

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Authors:  James M Parrish; Nathaniel W Jenkins; Thomas S Brundage; Nadia M Hrynewycz; Jeffrey Podnar; Asokumar Buvanendran; Kern Singh
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2.  Outpatient Versus Inpatient Anterior Lumbar Spine Surgery: A Multisite, Comparative Analysis of Patient Safety Measures.

Authors:  Jason M Cuellar; Edward Nomoto; Ehsan Saadat; Anthony Ma; Patrick Hill; Michael Kropf; Todd H Lanman; Brian Perri; Khawar Siddique; Willis Wagner; Rajeev Rao; Albert Wong; Michael Eng; Stephen Stephan; Neel Anand; Hyun Bae; Alexandre Rasouli
Journal:  Int J Spine Surg       Date:  2021-09-22

Review 3.  Complication avoidance and management in ambulatory spine surgery.

Authors:  Evan D Sheha; Peter B Derman
Journal:  J Spine Surg       Date:  2019-09

Review 4.  Lumbar spinal fusion in the outpatient setting: an update on management, surgical approaches and planning.

Authors:  Bryce A Basques; Joseph Ferguson; Kyle N Kunze; Frank M Phillips
Journal:  J Spine Surg       Date:  2019-09

5.  Anterior and Lateral Lumbar Interbody Fusion With Supplemental Interspinous Process Fixation: Outcomes from a Multicenter, Prospective, Randomized, Controlled Study.

Authors:  Ripul Panchal; Ryan Denhaese; Clint Hill; K Brandon Strenge; Alexandre DE Moura; Peter Passias; Paul Arnold; Andrew Cappuccino; M David Dennis; Andy Kranenburg; Brieta Ventimiglia; Kim Martin; Chris Ferry; Sarah Martineck; Camille Moore; Kee Kim
Journal:  Int J Spine Surg       Date:  2018-08-03

Review 6.  Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement of Staphylococcus aureus.

Authors:  Harshila Patel; Hanane Khoury; Douglas Girgenti; Sharon Welner; Holly Yu
Journal:  Surg Infect (Larchmt)       Date:  2016-11-30       Impact factor: 2.150

7.  Ambulatory Surgical Centers: Improving Quality of Operative Spine Care?

Authors:  Christopher D Witiw; Jefferson R Wilson; Michael G Fehlings; Vincent C Traynelis
Journal:  Global Spine J       Date:  2020-01-06

8.  Recoup From Home? Comparison of Relative Cost Savings for ACDF, Lumbar Discectomy, and Short Segment Fusion Performed in the Inpatient Versus Outpatient Setting.

Authors:  Christopher M Mikhail; Murray Echt; Stephen R Selverian; Samuel K Cho
Journal:  Global Spine J       Date:  2021-04

9.  Safety and Efficiency of Cervical Disc Arthroplasty in Ambulatory Surgery Centers vs. Hospital Settings.

Authors:  Matthew F Gornet; Glenn R Buttermann; Richard Wohns; Jason Billinghurst; Darrell C Brett; Richard Kube; J Rafe Sales; Nicholas J Wills; Ross Sherban; Francine W Schranck; Anne G Copay
Journal:  Int J Spine Surg       Date:  2018-10-15

10.  Outpatient Posterior Lumbar Fusion: A Population-Based Analysis of Trends and Complication Rates.

Authors:  Armin Arshi; Howard Y Park; Gideon W Blumstein; Christopher Wang; Zorica Buser; Jeffrey C Wang; Arya N Shamie; Don Y Park
Journal:  Spine (Phila Pa 1976)       Date:  2018-11-15       Impact factor: 3.241

  10 in total

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