Assessing clinical pathway in patients undergoing Love discectomy

Abstract

Love Discectomy is standard surgical method of lumbar disc herniation, removal of disc herniation after partial laminectomy. Since 1999, we have used clinical pathway, that is postoperative schedule for patients treated by Love Discectomy. This study was designed to assess the effectiveness of using clinical pathway, in determining the outcome of patients with lumbar disc herniation treated by Love Discectomy. 42 patients who received Love Discectomy were divided into two groups, and were treated and tracked postoperatively, (1) traditionally (26 patients) and (2) with clinical pathway (16 patients). Our postoperative schedule using clinical pathway considerations was, standing on 2nd day postoperatively, removal of sutures on 10th day, discharge from hospital on 14th day. We evaluated length of hospitalization after surgery, hospital charges, and clinical results of surgery. The period until standing postoperatively was shortened from 2.5 days to 2.0 days significantly. (p<0.05) Length of hospitalization after surgery was shortened from 18.8 days to 13.8 days. (p<0.005) Hospital charges decreased into 762,000 yen from 905,000 yen, significantly. (p<0.005) The difference of hospital treatment among the doctors was decreased clearly by utilizing the clinical pathway protocol. (p<0.005) Length of hospitalization and cost of treatment were significantly reduced, and the clinical results with or without clinical pathway were same. These results suggest that the clinical pathway was effective for standardizing the treatment after Love Discectomy.