• Jannik Leyendecker, Tobias Prasse, Christine Park, Malin Köster, Lena Rumswinkel, Tara Shenker, Eliana Bieler, Peer Eysel, Jan Bredow, Mark M Zaki, Varun Kathawate, Edward Harake, Rushikesh S Joshi, Sanjay Konakondla, Osama N Kashlan, Peter Derman, Albert Telfeian, Christoph P Hofstetter, and Endoscopic Spine Research Group (ESRG).
• Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
• Neurosurgery. 2024 Jul 18.

Background And ObjectivesEmergency department (ED) utilization and readmission rates after spine surgery are common quality of care measures. Limited data exist on the evaluation of quality indicators after full-endoscopic spine surgery (FESS). The objective of this study was to detect rates, causes, and risk factors for unplanned postoperative clinic utilization after FESS.MethodsThis retrospective multicenter analysis assessed ED utilization and clinic readmission rates after FESS performed between 01/2014 and 04/2023 for degenerative spinal pathologies. Outcome measures were ED utilizations, hospital readmissions, and revision surgeries within 90 days postsurgery.ResultsOur cohort includes 821 patients averaging 59 years of age, who underwent FESS. Most procedures targeted the lumbar or sacral spine (85.75%) while a small fraction involved the cervical spine (10.11%). The most common procedures were lumbar unilateral laminotomies for bilateral decompression (40.56%) and lumbar transforaminal discectomies (25.58%). Within 90 days postsurgery, 8.0% of patients revisited the ED for surgical complications. A total of 2.2% of patients were readmitted to a hospital of which 1.9% required revision surgery. Primary reasons for ED visits and clinic readmissions were postoperative pain exacerbation, transient neurogenic bladder dysfunction, and recurrent disk herniations. Our multivariate regression analysis revealed that female patients had a significantly higher likelihood of using the ED (P = .046; odds ratio: 1.77, 95% CI 1.01-3.1 5.69% vs 10.33%). Factors such as age, American Society of Anesthesiologists class, body mass index, comorbidities, and spanned spinal levels did not significantly predict postoperative ED utilization.ConclusionThis analysis demonstrates the safety of FESS, as evidenced by acceptable rates of ED utilization, clinic readmission, and revision surgery. Future studies are needed to further elucidate the safety profile of FESS in comparison with traditional spinal procedures.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

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