Our Summary

This study looked at the cost of two different types of anesthesia (substances to stop you feeling pain) used in lower back surgery. They analysed data from 542 patients who had either a diskectomy (removal of a disc in the spine) or laminectomy (removal of the back part of a vertebra) between 2007 and 2011. Of these, 364 had spinal anesthesia (where you are numb from the waist down) and 178 had general anesthesia (where you are completely unconscious).

The researchers compared the average direct cost of the operation, the indirect cost (such as insurance, staff, and facilities), and the total cost for both types of anesthesia. They also looked at other factors such as how long the patients stayed in hospital, how long the anesthesia and operation lasted, and how much blood was lost during surgery.

The results showed that spinal anesthesia was 41.1% cheaper for the direct operation cost, 36.6% cheaper for the indirect cost, and 39.6% cheaper in total compared to general anesthesia. This was partly because patients who had spinal anesthesia had shorter hospital stays, the anesthesia and operation took less time, and they lost less blood during surgery. But even when these factors were taken into account, spinal anesthesia was still cheaper.

So, the study concluded that spinal anesthesia is a less costly option for patients undergoing lower back surgery.

FAQs

  1. What types of anesthesia were compared in this study on lower back surgery?
  2. What were the key findings of the study in terms of costs and other factors such as hospital stay and blood loss?
  3. Is spinal anesthesia cheaper than general anesthesia for lower back surgery according to the study?

Doctor’s Tip

One helpful tip a doctor might give a patient about spinal laminectomy is to consider opting for spinal anesthesia instead of general anesthesia to potentially reduce the cost of the operation. This can lead to shorter hospital stays, quicker procedures, and less blood loss, ultimately saving money in the long run. It is important to discuss this option with your healthcare provider to determine the best choice for your individual situation.

Suitable For

Patients who are typically recommended spinal laminectomy are those who have spinal stenosis (narrowing of the spinal canal), herniated discs, or other conditions causing compression of the spinal cord or nerves in the lower back. These patients may be experiencing symptoms such as pain, numbness, weakness, or difficulty walking due to the compression. Spinal laminectomy is a common surgical procedure used to relieve pressure on the spinal cord or nerves by removing part of the vertebrae (lamina) to create more space in the spinal canal. It is often recommended when conservative treatments such as physical therapy, medications, or injections have not been effective in alleviating symptoms.

Timeline

Timeline before and after spinal laminectomy:

Before surgery:

  1. Patient consults with a doctor and undergoes diagnostic tests to determine the need for spinal laminectomy.
  2. Pre-operative preparation including fasting, medication adjustments, and medical history review.
  3. Anesthesia consultation to determine the type of anesthesia to be used during surgery.
  4. Patient is admitted to the hospital on the day of surgery.

During surgery:

  1. Patient is positioned on the operating table and anesthesia is administered.
  2. Surgical team performs the laminectomy procedure, removing part of the vertebral bone to relieve pressure on the spinal cord or nerves.
  3. Surgery typically lasts a few hours depending on the complexity of the case.
  4. Patient is monitored closely for any complications during surgery.

After surgery:

  1. Patient is taken to the recovery room to wake up from anesthesia.
  2. Pain medication is administered to manage post-operative pain.
  3. Physical therapy may be initiated to help with mobility and strength.
  4. Patient is monitored for any signs of infection, blood clots, or other complications.
  5. Patient may be discharged from the hospital within a few days or may require a longer hospital stay depending on their recovery.
  6. Follow-up appointments with the surgeon to monitor progress and address any concerns.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal laminectomy surgery?
  2. What is the recovery process like after a spinal laminectomy?
  3. How long will I need to stay in the hospital after the surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. Are there any alternative treatments or procedures that I should consider before opting for a spinal laminectomy?
  6. How long do the effects of spinal anesthesia typically last?
  7. What are the potential side effects of spinal anesthesia?
  8. How does spinal anesthesia compare to general anesthesia in terms of pain management during and after the surgery?
  9. What is the success rate of spinal laminectomy surgery?
  10. How soon can I expect to see improvement in my symptoms after the surgery?

Reference

Authors: Agarwal P, Pierce J, Welch WC. Journal: World Neurosurg. 2016 May;89:266-71. doi: 10.1016/j.wneu.2016.02.022. Epub 2016 Feb 11. PMID: 26875652