de Bree Karel, Atsma Femke, van Lindert Erik J, Westert Gert P, Bartels Ronald M H A
Department of Neurosurgery, Institute for Health Sciences, Radboud University Medical Centre, Postbus 9101, Geert Grooteplein Zuid 10, Nijmegen, 6500 HB, The Netherlands.
Scientific Center for Quality of Healthcare, Institute for Health Sciences, Radboud University Medical Centre, Postbus 9101, Geert Grooteplein 21, Nijmegen, 6500 HB, The Netherlands.
BMC Musculoskelet Disord. 2020 Sep 15;21(1):614. doi: 10.1186/s12891-020-03624-4.
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.
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.
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.
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.
在荷兰，目前大多数患者在接受颈椎前路椎间盘切除术后会在门诊就诊，这是一种有效的神经外科手术，严重并发症发生率相对较低。从这个角度来看，患者返回术后门诊就诊的必要性可能会受到质疑。本研究的目的是评估颈椎前路椎间盘切除术后的门诊预约是否可以被替代或省略，而不会对该手术的医疗保健价值和患者满意度产生不利影响或增加其风险。
进行了一项叙述性综述，以评估脊柱手术后有或没有术后门诊预约的患者的护理质量和患者满意度。在PubMed、CENTRAL和EMBASE上对过去十年的文献进行了检索。
共识别出403篇文章。由3名独立评审员进行标题和摘要筛选后，剩下4项研究。由于缺乏比较脊柱手术后门诊预约与干预措施效用的干预性研究，没有选择论文进行进一步分析。
目前，缺乏证据表明颈椎前路椎间盘切除术后需要进行术后随访。也没有任何文献支持省略这些预约。无法确定哪些患者能从这些门诊预约中受益。应调查省略这些术后随访的潜在有害和有益影响，以确定可能从术后预约中受益的患者的可能决定因素。
