AB086. SOH24AB_204. Day case discectomies: a feasible option in Ireland?

Background: From the USA to the UK, day case lumbar micro-discectomies have been seen to be a feasible, safe, and cost-efficient option in the management of select patients with lumbar disc herniation. In Ireland it remains however an underutilised option in the treatment.

Methods: A retrospective review was conducted on day case discectomies carried out by a single spinal surgeon between March and November 2023. Data from eleven patients who had undergone a day case discectomy were included. Data from 11 other comparable single level microdiscectomies that were carried out during this same time-period were also included in this review.

Results: Eleven day case single level lumbar micro-discectomy procedures and eleven non-day case single level lumbar microdiscectomy procedures were included for comparison. Average ages were 41 (range: 31–75 years) and 53 years (range: 38–75 years) respectively. Across both groups approximately 66% of patients were female, the average body mass index (BMI) was <30 kg/m² and all patients were American Society of Anaesthesiologists (ASA) grade <2. Of those in the day case group, 90% were successfully discharged home on the same day as the index surgery. One patient required a one-night stay in hospital due to hypotension. The average cost of a patient requiring an in-patient bed was calculated at €7,085 compared to €5,425 for a day case equivalent.

Conclusions: Day case single level lumbar micro-discectomies are a feasible option in carefully selected patients. There are clear financial benefits to employing this mode of surgical treatment without jeopardising the safety and satisfaction of patients.

Keywords: Discectomy; disc herniation; lumbar; orthopaedic; spinal