Need for post-operative outpatient appointments after discharge following cervical spinal surgery - a narrative review
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REVIEW
Open Access
Need for post-operative outpatient appointments after discharge following cervical spinal surgery - a narrative review Karel de Bree1* , Femke Atsma2, Erik J. van Lindert1, Gert P. Westert2 and Ronald M. H. A. Bartels1
Abstract Background: In the Netherlands most patients are currently seen in an outpatient clinic after an anterior cervical discectomy, which is an effective neurosurgical procedure with relatively low rate of severe complications. In this back sight, the need for patients returning to the post-operative outpatient clinic could be questioned. The aim of the study is to evaluate whether a post-operative outpatient appointment after anterior cervical discectomy could be replaced by an alternative or be omitted without adversely impacting, or increasing, the value of healthcare and patient satisfaction for this procedure. Methods: A narrative review was performed to evaluate the quality of care and patient satisfaction for patients with and without a post-operative outpatient appointment after spinal surgery. A literature search of the previous ten years was performed in Pubmed, CENTRAL and EMBASE. Results: A total of 403 articles were identified. Four studies remained after title and abstract selection by 3 independent reviewers. No papers were selected for further analysis, due to the absence of interventional studies that compared the utility of a post-operative outpatient clinic appointment with an intervention after spinal surgery. Conclusions: Currently, there is a lack of evidence for the need of a post-operative follow-up after anterior cervical discectomy. Nor is there any literature in favor of omitting these appointments. No determinants which patients benefits from these outpatient appointments could be identified. Potential harmful and beneficial effects of omitting these post-operative follow-ups should be investigated to identify possible determinant for patients who might benefit from a post-operative appointment. Keywords: Post-operative, Outpatient, Appointment, Spinal, Surgery, Omitting
Background Anterior cervical discectomy without fusion (ACD), with fusion (ACDF) or arthroplasty (ACDA) is a standard neurosurgical procedure for cervical radiculopathy or cervical stenosis. Success rates are up to 94% for cervical radiculopathy and the procedure has a relatively low rate for serious and permanent complications [1]. Supporting * Correspondence: [email protected] 1 Department of Neurosurgery, Institute for Health Sciences, Radboud University Medical Centre, Postbus 9101, Geert Grooteplein Zuid 10, Nijmegen 6500 HB, The Netherlands Full list of author information is available at the end of the article
evidence suggests that this procedure can be performed safe and effectively in the outpatient clinic [2]. This reduces hospital admission time, and with anticipation on potential complications in high risk patients, reduces admission related complications [3]. Furthermore, it reduces the patient disease burden and social costs. This illustrates efficient hea
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