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

Brief review

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

외래환자의 신경공경유요추체유합술 시행 가능성에 대한 예비결과

*Author: Alan T. Villavicencio, Ewell Lee Nelson, Alexander Mason, Sharad Rajpal, Sigita Burneikiene

*Bibliography: JSpinal Disord Tech. 2013 Aug;26(6):298-304

STUDY DESIGN: A retrospective chart review study

OBJECTIVE:

-The primary objective: To examine whether it is safe and effective to perform instrumented lumbar interbody fusions by comparing 2 groups (same day vs stayed overnight).

-The secondary objective: 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:

▶Subject number: Ambulatory Surgery Center(ASC): 27/  Hospital Outpatient Departments (HOD): 25

▶Mean age: 49.8 years (19-72 y)

▶evaluation method:

-The safety of outpatient lumbar fusions: analyzing complications that occurred when the seventh postoperative day (0-7 POD).

- The efficacy of surgical intervention: change in pain, patient satisfaction scores, and fusion rates

RESULTS:

-no cases of pneumonia, urinary tract infection, or thromboembolic complications.

-4 patients(14%) in ASC and 1 patient(4%) in HOD had complications within 7 days postoperatively.

-->not statistically significant in difference (P=0.36, Fisher exact test).

-Lower back and leg pain was significantly (P<0.0001) decreased postoperatively as follow.

>The average back pain: 74.5 (range: 0-100)  --> 18.8 (range: 0-90)

>The average leg pain: 54.2 (range, 0-100) --> 9.1 (range, 0-60)

*using 0-100 visual analog scale

CONCLUSIONS: 

This study discusses the possibility of performing instrumented lumbar interbody fusions with the transforaminal lumbar interbody fusion technique as an outpatient procedure.