Sheperd Courtney S, Young William F
Indiana University Medical School, Fort Wayne Center, Fort Wayne, Indiana 46805, USA.
Int Surg. 2012 Jan-Mar;97(1):86-9. doi: 10.9738/CC35.1.
Anterior cervical discectomy and fusion procedures are one of the most common procedures performed in spinal surgery. Increasingly they are being performed on an outpatient basis. The primary impetus for performing procedures as an outpatient is potential cost savings. However, there are few studies discussing the safety of performing the procedure in an ambulatory setting. This is a retrospective review of our initial experience in performing anterior cervical discectomy and fusion procedures with instrumentation (ACDFI) in an ambulatory surgery center dedicated to spine surgery. Patients were selected for outpatient surgery if they had limited co-morbidities and the surgery involved only 1 or 2 levels. One hundred fifty-two patients underwent outpatient ACDFI during the study period (2007-2009). Six patients returned to the hospital emergency room after discharge. The reasons for evaluation included 2 for neck pain, 1 for dysphagia, 1 for vocal cord paralysis and dysphagia, 1 for nausea, and 1 for cervical swelling. Only 1 of the 6 patients required admission to the hospital. None of the 6 suffered any long-term sequelae. The overall complication rate was 3.9%. A self-reported survey was completed by 75 patients within 6 months of surgery, and there was a 100% satisfaction rate among responders. ACDFI can be performed safely on an outpatient in selected patients with a high degree of patient satisfaction. Our experience is consistent with those of previous investigators.
颈椎前路椎间盘切除融合术是脊柱外科最常见的手术之一。越来越多的此类手术在门诊进行。门诊手术的主要推动力是潜在的成本节约。然而，很少有研究讨论在门诊环境中进行该手术的安全性。这是一项对我们在一家专门从事脊柱手术的门诊手术中心进行颈椎前路椎间盘切除融合内固定术（ACDFI）的初步经验的回顾性研究。如果患者合并症有限且手术仅涉及1或2个节段，则选择其进行门诊手术。在研究期间（2007 - 2009年），152例患者接受了门诊ACDFI手术。6例患者出院后返回医院急诊室。评估原因包括颈部疼痛2例、吞咽困难1例、声带麻痹和吞咽困难1例、恶心1例以及颈部肿胀1例。6例患者中只有1例需要住院。6例患者均未出现任何长期后遗症。总体并发症发生率为3.9%。75例患者在术后6个月内完成了一份自我报告调查，应答者的满意率为100%。在选定的患者中，门诊进行ACDFI手术可以安全地进行，患者满意度较高。我们的经验与之前研究者的经验一致。
