Postoperative Outcomes and Resource Utilization Following Open vs Endoscopic Far Lateral Lumbar Discectomy
This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com..
BACKGROUND: Operative approaches for far lateral disc herniation (FLDH) repair may be classified as open or minimally invasive. The present study aims to compare postoperative outcomes and resource utilization between patients undergoing open and endoscopic (one such minimally invasive approach) FLDH surgeries.
METHODS: A total of 144 consecutive adult patients undergoing FLDH repair at a single, university health system over an 8-year period (2013-2020) were retrospectively reviewed. Patients were divided into 2 cohorts: "open" (n = 92) and "endoscopic" (n = 52). Logistic regression was performed to evaluate the impact of procedural type on postoperative outcomes, and resource utilization metrics were compared between cohorts using χ 2 test (for categorical variables) or t test (for continuous variables). Primary postsurgical outcomes included readmissions, reoperations, emergency department visits, and neurosurgery outpatient office visits within 90 days of the index operation. Primary resource utilization outcomes included total direct cost of the procedure and length of stay. Secondary measures included discharge disposition, operative length, and duration of follow-up.
RESULTS: No differences were observed in adverse postoperative events. Patients undergoing open FLDH surgery were more likely to attend outpatient visits within 30 days (P = 0.016). Although direct operating room cost was lower (P < 0.001) for open procedures, length of hospital stay was longer (P < 0.001). Patients undergoing open surgery also demonstrated less favorable discharge dispositions, longer operative length, and greater duration of follow-up.
CONCLUSIONS: While both procedure types represent viable options for FLDH, endoscopic surgeries appear to achieve comparable clinical outcomes with decreased perioperative resource utilization.
CLINICAL RELEVANCE: The present study suggests that endoscopic FLDH repairs do not lead to inferior outcomes but may decrease utilization of perioperative resources.
LEVEL OF EVIDENCE: 3:.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
International journal of spine surgery - 17(2023), 3 vom: 20. Juni, Seite 350-355 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Connolly, John [VerfasserIn] |
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| Links: |
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| Themen: |
Endoscopic surgery |
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| Anmerkungen: |
Date Revised 04.07.2023 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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| doi: |
10.14444/8443 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM353880566 |
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| 245 | 1 | 0 | |a Postoperative Outcomes and Resource Utilization Following Open vs Endoscopic Far Lateral Lumbar Discectomy |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2023 ISASS. To see more or order reprints or permissions, see http://ijssurgery.com. | ||
| 520 | |a BACKGROUND: Operative approaches for far lateral disc herniation (FLDH) repair may be classified as open or minimally invasive. The present study aims to compare postoperative outcomes and resource utilization between patients undergoing open and endoscopic (one such minimally invasive approach) FLDH surgeries | ||
| 520 | |a METHODS: A total of 144 consecutive adult patients undergoing FLDH repair at a single, university health system over an 8-year period (2013-2020) were retrospectively reviewed. Patients were divided into 2 cohorts: "open" (n = 92) and "endoscopic" (n = 52). Logistic regression was performed to evaluate the impact of procedural type on postoperative outcomes, and resource utilization metrics were compared between cohorts using χ 2 test (for categorical variables) or t test (for continuous variables). Primary postsurgical outcomes included readmissions, reoperations, emergency department visits, and neurosurgery outpatient office visits within 90 days of the index operation. Primary resource utilization outcomes included total direct cost of the procedure and length of stay. Secondary measures included discharge disposition, operative length, and duration of follow-up | ||
| 520 | |a RESULTS: No differences were observed in adverse postoperative events. Patients undergoing open FLDH surgery were more likely to attend outpatient visits within 30 days (P = 0.016). Although direct operating room cost was lower (P < 0.001) for open procedures, length of hospital stay was longer (P < 0.001). Patients undergoing open surgery also demonstrated less favorable discharge dispositions, longer operative length, and greater duration of follow-up | ||
| 520 | |a CONCLUSIONS: While both procedure types represent viable options for FLDH, endoscopic surgeries appear to achieve comparable clinical outcomes with decreased perioperative resource utilization | ||
| 520 | |a CLINICAL RELEVANCE: The present study suggests that endoscopic FLDH repairs do not lead to inferior outcomes but may decrease utilization of perioperative resources | ||
| 520 | |a LEVEL OF EVIDENCE: 3: | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a endoscopic surgery | |
| 650 | 4 | |a far lateral disc herniation | |
| 650 | 4 | |a lumbar spine | |
| 650 | 4 | |a minimally invasive surgery | |
| 650 | 4 | |a spine surgery | |
| 700 | 1 | |a Borja, Austin J |e verfasserin |4 aut | |
| 700 | 1 | |a Kvint, Svetlana |e verfasserin |4 aut | |
| 700 | 1 | |a Glauser, Gregory |e verfasserin |4 aut | |
| 700 | 1 | |a Strouz, Krista |e verfasserin |4 aut | |
| 700 | 1 | |a McClintock, Scott D |e verfasserin |4 aut | |
| 700 | 1 | |a Marcotte, Paul J |e verfasserin |4 aut | |
| 700 | 1 | |a Malhotra, Neil R |e verfasserin |4 aut | |
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