Day case lumbar discectomy – Viable option in the UK?

Abstract

Introduction. The inpatient length of stay for lumbar discectomy has been steadily declining, since its original description over 80 years ago. The operation was first described as a day case procedure in 1987, but only sporadically since then, especially in the UK. We describe our initial experience in introducing this service in Manchester. Methods. Over a 2-year period, 50 of 80 patients undergoing lumbar discectomy met the inclusion criteria for day case surgery, using standard microscopic techniques and admission via a day case unit. Results. Majority (N = 48) were single level, unilateral discectomies and 36 (72%) were discharged home the same day. The remainder (28%) were discharged after an overnight stay and within 24 h. Reasons for this included post-operative back pain and hypotension. Majority (N = 47), reported improvement or resolution of pre-operative back and leg pain, which was quantified using Visual analogue scores (p < 0.01). Conclusions. Lumbar microdiscectomy as a day case procedure remains a feasible and safe option in selected patients and can help free up in patient beds with a significant economic benefit also.