Department of orthopaedicsurgery, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate, 10, 1200 Brussels, Belgium.
Eur Spine J. 2013 Aug;22(8):1868-76. doi: 10.1007/s00586-013-2691-y. Epub 2013 Feb 9.
To examine the time needed from a surgeon's viewpoint to treat a patient operated for lumbar spinal stenosis. We firstly aimed to give evidence of the wide ranging duration of standardized procedure. Secondly, we investigated factors affecting the time allocated to each patient.
438 medical records of patients operated on for lumbar decompression without fusion (2005-2011) were retrospectively examined. Primary data were operative time (OT, min), length of stay (LoS, days) and number of postoperative visits. A fourth parameter was calculated, the time spent per patient (TSPP, min) by summing the time spent in surgery, during inpatient and outpatient follow-up visits. Factors that influenced these medical resources were examined.
Median (5th-95th percentile) LoS was 5 days (2-15), OT 106 min (60-194), number of medical visits 5 (2-11) and TSPP 329 min (206-533). In descending order, factors predicting LoS were age, no. of levels, sex, operative technique, cardiovascular risk index, dural tear and haematoma. Factors predicting OT were number of levels, dural tear, foraminotomy, synovial cyst and body mass index. The statistical model could predict 36% of the TSPP variance. We recommend that surgeons add 35 min for each level, 29 min for patients over 65 years, 30 min for women, 132 min for dural tear and 108 min for epidural haematoma.
TSPP treated for lumbar spinal stenosis is highly variable, yet partially predictable. These data may help individual surgeons or heads of departments to plan their activities.
从外科医生的角度检查治疗腰椎管狭窄症患者所需的时间。我们首先旨在提供标准化手术过程所需时间范围广泛的证据。其次，我们研究了影响每位患者分配时间的因素。
回顾性检查了 438 例接受腰椎减压无融合手术（2005-2011 年）的患者的病历。主要数据为手术时间（OT，分钟）、住院时间（LoS，天）和术后就诊次数。通过将手术期间、住院和门诊随访期间花费的时间相加，计算出每个患者的时间分配（TSPP，分钟）。检查了影响这些医疗资源的因素。
中位（5 至 95 百分位数）LoS 为 5 天（2-15），OT 为 106 分钟（60-194），就诊次数为 5 次（2-11），TSPP 为 329 分钟（206-533）。按降序排列，预测 LoS 的因素为年龄、水平数、性别、手术技术、心血管风险指数、硬脑膜撕裂和血肿。预测 OT 的因素为水平数、硬脑膜撕裂、椎间孔切开术、滑膜囊肿和体重指数。统计模型可以预测 TSPP 方差的 36%。我们建议外科医生每增加一个水平增加 35 分钟，65 岁以上的患者增加 29 分钟，女性增加 30 分钟，硬脑膜撕裂增加 132 分钟，硬膜外血肿增加 108 分钟。
治疗腰椎管狭窄症的 TSPP 差异很大，但部分可预测。这些数据可以帮助外科医生或科室主任规划他们的活动。
