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内镜脊柱手术:患者为接受微创脊柱手术愿意前往的距离。

Endoscopic Spine Surgery: Distance Patients Will Travel for Minimally Invasive Spine Surgery.

作者信息

Telfeian Albert E, Iprenburg Menno, Wagner Ralf

机构信息

Brown University.

出版信息

Pain Physician. 2017 Jan-Feb;20(1):E145-E149.

PMID:28072806
Abstract

BACKGROUND

Transforaminal lumbar endoscopic discectomy is a minimally invasive spine surgery procedure performed principally for the treatment of lumbar herniated discs. Endoscopic spine surgeons around the world have noted how far patients will travel to undergo this minimally invasive spine surgery, but the actual distance patients travel has never been investigated.

OBJECTIVE

We present here our analysis of how far patients will travel for endoscopic spine surgery by studying the referral patterns of patients to 3 centers in 3 different countries.

STUDY DESIGN

Retrospective chart review of de-identified patient data was performed to analyze the distance patients travel for spine surgery.

METHODS

Patient demographic data was analyzed for patients undergoing transforaminal lumbar endoscopic discectomy procedures over the same 8 month period in 2015 at centers in the United States (U.S.), Netherlands, and Germany.

RESULTS

Travel distances for patients were determined for 327 patients. The average distance traveled for the U.S. center was 91 miles, the Dutch center was 287 miles, and the German center was 103 miles. For the U.S. center 16% of patients traveled out of state for surgery and for the European centers combined, 4% of patients traveled out of the country for surgery.

LIMITATIONS

The period of data analyzed was less than one year and the data collected was analyzed retrospectively.

CONCLUSIONS

Quality metrics in health care tend to be focused on how health care is delivered. Another health care metric that focuses more on what patients desire is presented here: how far patients will travel for innovative spine care.Key words: Endoscopic spine surgery, transforaminal, minimally invasive, travel, lumbar disc herniation.

摘要

背景

经椎间孔腰椎内镜下椎间盘切除术是一种主要用于治疗腰椎间盘突出症的微创脊柱外科手术。世界各地的脊柱内镜外科医生都注意到患者愿意前往多远的地方接受这种微创脊柱手术,但患者实际出行的距离从未被研究过。

目的

我们通过研究患者转诊至3个不同国家的3个中心的模式,来分析患者愿意前往多远的地方接受脊柱内镜手术。

研究设计

对去识别化的患者数据进行回顾性图表审查,以分析患者接受脊柱手术的出行距离。

方法

分析了2015年在美国、荷兰和德国的中心接受经椎间孔腰椎内镜下椎间盘切除术的患者在相同8个月期间的人口统计学数据。

结果

确定了327例患者的出行距离。美国中心患者的平均出行距离为91英里,荷兰中心为287英里,德国中心为103英里。在美国中心,16%的患者跨州进行手术,而在欧洲中心合并计算,4%的患者出国进行手术。

局限性

分析的数据时间段不到一年,且收集的数据是回顾性分析的。

结论

医疗保健中的质量指标往往侧重于医疗保健的提供方式。这里提出了另一个更关注患者需求的医疗保健指标:患者愿意为创新的脊柱治疗出行多远。关键词:脊柱内镜手术、经椎间孔、微创、出行、腰椎间盘突出症

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