Our Summary

This research paper looks at the number of patients who visit the emergency department (ED) after having a common type of back surgery called a lumbar discectomy. This type of surgery is often followed by ED visits, which can indicate the quality of care, impact patient satisfaction, and contribute to healthcare costs. The study aims to understand when these visits typically occur and what factors might predict them.

The analysis used a dataset of patients who had the surgery between 2010 and 2021. The researchers focused on several factors, including the patient’s age, sex, overall health, where in the U.S. the surgery was performed, and their insurance plan. They also looked at how often patients visited the ED in the 90 days following surgery and the reasons for those visits.

The results showed that over 10% of patients visited the ED within 90 days of their surgery, with 40% of these visits happening within the first two weeks after the surgery. Factors that predicted these ED visits included younger age, being female, poorer overall health, having the surgery in the Northeast, Midwest, or West U.S., and having Medicaid insurance. The most common reason for visiting the ED was pain at the surgical site.

Of those who visited the ED, around 3.3% had another operation within the next two weeks. The most common type of these additional surgeries was a procedure to relieve pressure on a nerve root.

In conclusion, the study suggests that healthcare providers could use this information to help reduce the number of patients needing to visit the ED after a lumbar discectomy. This could lead to improved patient satisfaction, better outcomes, and reduced healthcare costs.

FAQs

  1. What factors can predict emergency department visits after a lumbar discectomy?
  2. When do most emergency department visits occur after a lumbar discectomy?
  3. What was the most common reason for patients to visit the emergency department following a lumbar discectomy?

Doctor’s Tip

One helpful tip a doctor might give a patient about discectomy is to follow post-operative care instructions carefully, including proper wound care, physical therapy, and pain management. It is important to avoid activities that could strain the surgical site and to report any unusual symptoms or increased pain to your healthcare provider promptly. By following these recommendations, you can help reduce the risk of complications and improve your recovery process.

Suitable For

Patients who are typically recommended for a discectomy are those who have herniated or bulging discs in the spine that are causing significant pain, weakness, and/or numbness in the back, legs, or arms. These patients may have tried conservative treatments such as physical therapy, medication, and epidural steroid injections without success. Additionally, patients who have severe neurological symptoms such as difficulty walking, loss of bowel or bladder control, or progressive weakness in the legs may also be recommended for a discectomy to prevent further nerve damage. Ultimately, the decision to undergo a discectomy should be made in consultation with a spine specialist after a thorough evaluation of the patient’s symptoms, medical history, and imaging studies.

Timeline

Before discectomy:

  • Patient experiences persistent back pain, leg pain, or numbness
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm a herniated disc
  • Patient consults with a surgeon to discuss the option of discectomy
  • Surgery is scheduled and patient undergoes pre-operative evaluations and preparations

After discectomy:

  • Patient undergoes surgery to remove the herniated disc
  • Patient is monitored in the hospital for a period of time post-surgery
  • Patient is discharged with instructions for post-operative care, including physical therapy and pain management
  • Patient may experience some pain and discomfort in the immediate post-operative period
  • Patient gradually resumes normal activities and physical therapy to strengthen the back muscles
  • Patient may experience improvement in symptoms and reduction in pain over time
  • Patient may need to visit the emergency department if they experience severe pain, infection, or other complications post-surgery

Overall, the timeline for a patient before and after discectomy involves a period of evaluation, surgery, recovery, and rehabilitation to improve symptoms and quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about discectomy include:

  1. What are the potential risks and complications associated with a discectomy surgery?
  2. How long is the recovery process after a discectomy surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What activities should I avoid or modify after the surgery to prevent re-injury?
  5. How soon can I expect to see improvement in my symptoms after the surgery?
  6. Are there any alternative treatment options to consider before opting for surgery?
  7. What is the success rate of discectomy surgery for patients with similar conditions?
  8. Will I need any follow-up appointments or tests after the surgery?
  9. How can I manage pain and discomfort during the recovery period?
  10. What lifestyle changes can I make to support the healing process and prevent future back issues?

Reference

Authors: Ratnasamy PP, Rudisill KE, Caruana DL, Kammien AJ, Grauer JN. Journal: Spine J. 2023 Oct;23(10):1522-1530. doi: 10.1016/j.spinee.2023.06.384. Epub 2023 Jun 24. PMID: 37356460