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Retrospective single-centre series of 1300 consecutive cases of outpatient cervical spine surgery: complications, hospital readmissions, and reoperations
- Source :
- British journal of neurosurgery. 33(6)
- Publication Year :
- 2019
-
Abstract
- Background: Outpatient surgery is becoming more common and is more cost-effective than inpatient surgery. Nonetheless, many surgeons and health care administrators are still hesitant to accept outpatient surgery for cervical degenerative spinal disease (C-DSD). This study assesses the types and rates of complications, hospital admissions, and reoperations after outpatient surgery of C-DSD.Methods: Complications, hospital admissions within 90 days of surgery, and reoperations within one year of surgery were recorded retrospectively in 1300 outpatients undergoing microsurgical decompression for C-DSD at the Oslofjord Clinic from 2008 to 2017. The surgical procedures performed were anterior cervical decompression and fusion (ACDF) in 1083 patients and posterior cervical foraminotomy in 217 patients.Results: The surgical mortality rate was 0%. Sixteen major complications were recorded in 15/1300 (1.2%) patients. The complications were neurological deterioration in four patients, postoperative hematoma in two, dural lesions with cerebrospinal fluid leakage in one, deep surgical-site infection in one, persistent hoarseness in three, and persistent dysphagia in five. The two potentially life-threatening hematomas were detected within the planned six-hour observation period. Two (0.2%) patients were admitted to hospital within hours of surgery completion with stroke-like signs and symptoms, and four (0.3%) patients were admitted to hospital within 90 days due to surgery-related events. The rate of reoperations for cervical radiculopathy within 12 months was 25/1171 (2%); eight patients' reoperations were due to inadequate primary decompression, one was due to recurrent disc herniation at the same level and side, and 16 were due to new-onset radiculopathy from an adjacent level or other side.Conclusions: Outpatient microsurgical decompression of the degenerative cervical spine in carefully selected patients appears to be safe and carries a low major complication rate, low hospital admission rate, and low one-year reoperation rate.
- Subjects :
- Adult
Male
Reoperation
medicine.medical_specialty
Adolescent
Decompression
medicine.medical_treatment
Postoperative hematoma
Outpatient surgery
Operative Time
Intervertebral Disc Degeneration
Spinal disease
Patient Readmission
Neurosurgical Procedures
03 medical and health sciences
Young Adult
0302 clinical medicine
Postoperative Complications
Foraminotomy
Recurrence
medicine
Cervical spondylosis
Humans
Radiculopathy
Aged
Retrospective Studies
Aged, 80 and over
business.industry
General Medicine
Middle Aged
medicine.disease
Decompression, Surgical
Dysphagia
Surgery
Spinal Fusion
Treatment Outcome
Ambulatory Surgical Procedures
030220 oncology & carcinogenesis
Hospital admission
Cervical Vertebrae
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Intervertebral Disc Displacement
Subjects
Details
- ISSN :
- 1360046X
- Volume :
- 33
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- British journal of neurosurgery
- Accession number :
- edsair.doi.dedup.....b342c34490ef61de990cf9497ddb2fae