gms | German Medical Science

Objective: Readmissions and reoperations within the first few months of surgery are major factors driving negative clinical and financial outcomes. We evaluated the rates of delayed discharge and readmission after primary lumbar discectomy within the first 30, 60 and 90 days after surgery in patients treated with a bone-anchored ACD (treatment group) compared with discectomy alone (control group).

Methods: The study population consists of 545 subjects (278 control and 267 treatment group) from an RCT to demonstrate superiority of discectomy with ACD relative to discectomy alone. Key inclusion criteria include 6 weeks of failed conservative treatment, posterior disc height of ≥5mm, minimum defect width and height, and baseline ODI and VAS leg pain ≥40/100. This report presents cost, safety, and early readmission results within the first 30, 60 and 90 days after surgery based on an analyses of site reported adverse events and reoperations of the index level.

Results: Statistically significant differences in the incidence of procedure- or device-related readmissions, delayed discharges, and index-level reoperations were observed within the first 30, 60, and 90 days (p<0.045), with a substantially lower rate being observed in implanted subjects compared with the control group (3.7% vs. 7.9% ≤ 90 days). Within the first 90 days, Control subjects underwent 2.5 times more reoperations. Table 1 [Tab. 1].

Conclusion: Discectomy with bone-anchored ACD was associated with lower rates of device- or procedure- related reoperations, early readmissions or delayed discharges and associated costs compared to discectomy alone. These results suggest that bone-anchored ACD could play an important role in reducing short-term clinical and financial burdens following lumbar discectomy.