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New Trends in Lumbar Spine Surgery

People who collect data about health care patterns are called epidemiologists. Information of this kind can help doctors, hospitals, and clinics plan ahead to provide needed services. In this study, figures on lumbar spine surgery are reported from the National Hospital Discharge Survey (NHDS).

Some change in trends was observed. Rates of inpatient spine surgery are steady now after 20 years of annual increases. Outpatient surgery for disc problems is very common. When a patient has surgery and goes home on the same day, it's called outpatient or ambulatory surgery.

Most of the outpatient lumbar spine procedures done were discectomies (removal of the disc). A small number of ambulatory spinal fusions and laminectomies were also done but the rate of these operations doubled from 1997 to 2000. A laminectomy is the removal of bone from the vertebral ring around the spinal cord.

The recent change in outpatient surgery patterns impacts the delivery of health care. A shorter hospital or clinic stay means more care at home. Patient and families will be required to monitor for infection, blood clots, nerve damage, and other complications.

Costs may shift from insurance to the patient. Hospital income may go down while outpatient services such as home health will increase. Changing trends in health care driven by advancing technology and the need to reduce costs may really only shift (not decrease) costs.

Finally, the collection of data may need to be changed. Research including both inpatient and outpatient trends is advised. Studies are also needed to focus on quality of care and patient safety with ambulatory procedures.

References: Darryl T. Gray, MD, ScD, et al. Population-Based Trends in Volumes and Rates of Ambulatory Lumbar Spine Surgery. In Spine. August 1, 2006. Vol. 31. No. 17. Pp. 1957-1963.

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