Research Associate New York Brain & Spine Surgery, United States
Introduction: The goal of this study was to develop a standardized post-operative treatment protocol for common spine procedures to improve outcome while reducing cost thereby maintaining quality.
Methods: We developed a Best Practices Protocol (BPP) for post-operative spine care for Microdiskectomy (MLD), Anterior Cervical Diskectomy & Fusion (ACDF), and Posterior Lumbar Interbody Fusion (PLIF). We compared outcome to retrospective controls (Pre-Best Practices Protocol) and a National Database (QOD/ASR).
Results: Pre-BPP retrospective controls (n = 1,010) were compared to patients enrolled in BPP (n = 750). BPP reduced post-operative visits (POV) from 2,201 to 1,061(52%). Total additional imaging studies (CT/MRI) were reduced from 192 studies to 57 (70%); 53% for lumbar fusion and 67% for cervical fusion. Comparing Pre-BPP to BPP groups for complications, the number of adverse events was reduced by 52% overall; 45% for lumbar fusion, and 62% for cervical fusion. BPP patients (n = 450) were compared to a national registry (QOD/ASR) where lumbar and cervical fusion patients showed comparable less lengths of stay, lower 3-month complication rates and lower readmission rates.
Conclusion : This is one of the first studies to standardize post-operative spine care into a simple protocol that shows maintains or improves quality while reducing cost compared to a national data registry.
