The Cumbria Spinal Service- 5 year audits of micro-discectomy and micro-decompression

BACKGROUND CONTEXT: In 2008 Cumbria Orthopaedic Surgeons ceased spinal surgery meaning no local provision was available. Spinecare UK negotiated a contract providing surgeon led triage Clinics in 3 NHS locations in Cumbria. PURPOSE: To demonstrate a private company can provide a high quality service with audited outcomes of micro-discectomy and microdecompression. STUDY DESIGN/SETTING: Patients listed for lumber decompression or microdiscectomy were assessed preoperatively and then followed up 12 months post-operatively. PATIENT SAMPLE: 326 Spinecare records of patients who underwent a lumbar decompression or micro-discectomy between 2009-13 were analysed. OUTCOME MEASURES: 3 outcome measures were used: Oswestry Disability Index Score (ODI);Pain Analogue Score and patient satisfaction METHODS: 277 patients were contacted 12 months post-surgery and the post-operative ODI, pain and satisfaction scores were recorded and compared to pre-operative data. RESULTS: Decompression patients showed a mean ODI improvement (12%) and 3.0 point pain scale reduction. Micro-discectomy patients showed a mean ODI improvement (22.4%) and 4.3 point pain reduction. Low complication rates (5.4% Dural tears, 1.4% infection) and complications did not adversely affect outcome. 97% of patients were either satisfied or highly satisfied with their level of care and post-operative outcome. CONCLUSIONS: Patients showed a highly significant improvement in ODI and pain reduction one year post surgery with a low rate of surgical complication and high level of patient satisfaction. Spinecare with the support of local facilities provides a high quality service with robust audit data. We continue to provide this as sub-contractor to Spire Healthcare. CONFLICTS OF INTEREST: None. FUNDING SOURCES: None.