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Time spent per patient in lumbar spinal stenosis surgery.

Abstract

PURPOSE

To examine the time needed from a surgeon's viewpoint to treat a patient operated for lumbar spinal stenosis. We firstly aimed to give evidence of the wide ranging duration of standardized procedure. Secondly, we investigated factors affecting the time allocated to each patient.

METHODS

438 medical records of patients operated on for lumbar decompression without fusion (2005-2011) were retrospectively examined. Primary data were operative time (OT, min), length of stay (LoS, days) and number of postoperative visits. A fourth parameter was calculated, the time spent per patient (TSPP, min) by summing the time spent in surgery, during inpatient and outpatient follow-up visits. Factors that influenced these medical resources were examined.

RESULTS

Median (5th-95th percentile) LoS was 5 days (2-15), OT 106 min (60-194), number of medical visits 5 (2-11) and TSPP 329 min (206-533). In descending order, factors predicting LoS were age, no. of levels, sex, operative technique, cardiovascular risk index, dural tear and haematoma. Factors predicting OT were number of levels, dural tear, foraminotomy, synovial cyst and body mass index. The statistical model could predict 36% of the TSPP variance. We recommend that surgeons add 35 min for each level, 29 min for patients over 65 years, 30 min for women, 132 min for dural tear and 108 min for epidural haematoma.

CONCLUSION

TSPP treated for lumbar spinal stenosis is highly variable, yet partially predictable. These data may help individual surgeons or heads of departments to plan their activities.

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  • Authors+Show Affiliations

    ,

    Department of orthopaedicsurgery, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200 Brussels, Belgium. kaminski.ludovic@gmail.com

    Source

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Body Mass Index
    Female
    Humans
    Length of Stay
    Lumbar Vertebrae
    Male
    Middle Aged
    Operative Time
    Orthopedic Procedures
    Postoperative Care
    Retrospective Studies
    Sex Factors
    Spinal Stenosis

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23397190

    Citation

    TY - JOUR T1 - Time spent per patient in lumbar spinal stenosis surgery. AU - Kaminski,Ludovic, AU - Banse,Xavier, Y1 - 2013/02/09/ PY - 2012/09/13/received PY - 2013/01/25/accepted PY - 2012/12/09/revised PY - 2013/2/12/entrez PY - 2013/2/12/pubmed PY - 2014/5/29/medline SP - 1868 EP - 76 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 22 IS - 8 N2 - PURPOSE: To examine the time needed from a surgeon's viewpoint to treat a patient operated for lumbar spinal stenosis. We firstly aimed to give evidence of the wide ranging duration of standardized procedure. Secondly, we investigated factors affecting the time allocated to each patient. METHODS: 438 medical records of patients operated on for lumbar decompression without fusion (2005-2011) were retrospectively examined. Primary data were operative time (OT, min), length of stay (LoS, days) and number of postoperative visits. A fourth parameter was calculated, the time spent per patient (TSPP, min) by summing the time spent in surgery, during inpatient and outpatient follow-up visits. Factors that influenced these medical resources were examined. RESULTS: Median (5th-95th percentile) LoS was 5 days (2-15), OT 106 min (60-194), number of medical visits 5 (2-11) and TSPP 329 min (206-533). In descending order, factors predicting LoS were age, no. of levels, sex, operative technique, cardiovascular risk index, dural tear and haematoma. Factors predicting OT were number of levels, dural tear, foraminotomy, synovial cyst and body mass index. The statistical model could predict 36% of the TSPP variance. We recommend that surgeons add 35 min for each level, 29 min for patients over 65 years, 30 min for women, 132 min for dural tear and 108 min for epidural haematoma. CONCLUSION: TSPP treated for lumbar spinal stenosis is highly variable, yet partially predictable. These data may help individual surgeons or heads of departments to plan their activities. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/23397190/Time_spent_per_patient_in_lumbar_spinal_stenosis_surgery_ L2 - https://doi.org/10.1007/s00586-013-2691-y ER -