[Pre- and postoperative fast-track treatment concepts in spinal surgery : patient information and patient cooperation].

BACKGROUND: Evidence-based procedures and pathways to reduce peri- and postoperative complications, while simultaneously achieving a high satisfaction rate of patients and lower costs are important goals in the treatment of orthopedic patients.
PURPOSE: This article describes the key factors to improve treatment of patients with indications for stabilization of one or two segments in the field of degenerative lumbar spine pathologies. A fast-track concept was developed to optimize the pathway of treatment, while increasing patient satisfaction and shortening the hospital stay. In the present patient cohort, significantly greater patient satisfaction and significantly shorter hospital stays were achieved.
RESULTS: The hospital stay was reduced from 10.9 to 6.2 days after introduction of a multimodal patient school that was held 10 days prior to admission, with mobilization on the day of surgery with a strictly followed treatment plan supervised by therapists and taking into account the patient's own assessment, as well an early plan for discharge based on fixed established criteria. This concept is a very successful tool to achieve high quality standard of treatment paired with a reduction of hospital stay.