• Øystein Helseth, Bjarne Lied, Charlotte Marie Halvorsen, Kåre Ekseth, and Eirik Helseth.
• *Oslofjordklinikken, Sandvika, Norway; ‡Faculty of Medicine, University of Bergen, Bergen, Norway; §Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; ¶Faculty of Medicine, University of Oslo, Oslo, Norway.
• Neurosurgery. 2015 Jun 1;76(6):728-37; discussion 737-8.

BackgroundThere is an increasing demand for surgery of degenerative spinal disease. Limited healthcare resources draw attention to the need for cost-effective treatments. Outpatient surgery, when safe and feasible, is more cost effective than inpatient surgery.ObjectiveTo study types and rates of complications after outpatient lumbar and cervical spine decompressions.MethodsComplications were recorded prospectively in 1449 (1073 lumbar, 376 cervical) outpatients undergoing microsurgical decompression for degenerative spinal disease at the private Oslofjord Clinic from 2008 to 2013.ResultsSurgical mortality was 0%. A total of 51 (3.5%) minor and major complications were recorded in 51 patients. Three (0.2%) patients had to be admitted to a hospital the day of surgery. Twenty-two (1.5%) patients were admitted to a hospital within 3 months due to surgery-related events. The encountered complications were postoperative hematoma (0.6%), neurological deterioration (0.3%), deep wound infection (0.9%), dural lesions with cerebrospinal fluid leakage (1.0%), persistent dysphagia (0.1%), persistent hoarseness (0.1%), and severe pain/headache (0.4%). All of the life-threatening hematomas were detected within 6 and 3 hours after cervical and lumbar surgery, respectively.ConclusionThis series of 1449 consecutive outpatient microsurgical spine decompressions adds to the growing literature in favor of outpatient spinal surgery in properly selected patients. In our study, 99.8% of the patients were successfully discharged either to their homes or to a hotel on the day of surgery. The overall complication rate was 3.5%, surgical mortality was 0%, and only 1.5% had to be admitted to a hospital within 3 months after surgery.

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