Abstract
We report postoperative rehabilitation program without cervical orthosis for cervical laminoplasty. By reviewing the outcome (criteria for discharge, the length of hospital stay) we could make the postoperative rehabilitation program earlier than before. At first the length of hospital stay was set at 4 weeks. After reviewing with the path, it was changed 2 weeks at last. The average time to start the sitting position, standing position and walking alone was 3.3±2.7 days, 4.3±2.7 days, 7.0±8.1 days with 4-weeks path, 1.2±0.4 days, 2.2±1.0 days, 4.1±2.3 days with 3-weeks path and 1.0±0.0 day, 1.6±1.7 days, 3.1±3.0 days with 2-weeks. Guidance and explanation on the training before operation made the postoperative training smooth. When we start ambulation immediately after surgery without cervical orthosis, we must pay attention to the motion of getting up. In the variance examination, there was no negative variance in the case of patients who walk early after surgery. The rate of hospital change was about 40% in each path. For the cases under consideration for postoperative hospital change, effects are being made to share information by using the exclusive path which was jointly developed by our hospital and the hospital to which we introduce patients. The critical path is a useful tool to manage the outcome of medical treatment.
