What is the usual discharge time from hospital after lumbar disc surgery with plating?

Usual Discharge Time After Lumbar Disc Surgery with Plating

The usual discharge time after lumbar disc surgery with plating is typically 1-3 days post-surgery, with most patients being discharged when they can ambulate independently, have adequate pain control, and show no signs of complications. 1

Discharge Criteria

Patients are typically ready for discharge from hospital when they meet the following criteria:

• Return of normal reflexes and adequate pain control 1
• Ability to ambulate independently or with minimal assistance 1
• No signs of significant complications such as infection, neurological deficits, or excessive bleeding 1
• Patients may be discharged before traditional criteria like tolerating oral fluids or passing urine are met, as these are no longer strictly enforced in many cases 1

Timeline for Post-Operative Recovery

The recovery process after lumbar disc surgery can be divided into several stages:

• First stage recovery: Occurs in the immediate post-operative period, focusing on emergence from anesthesia and initial stabilization 1
• Second stage recovery: Ends when the patient is ready for discharge from hospital (typically 1-3 days) 1
• Late recovery: May take several weeks to months for full physiological and psychological recovery 1

Physical Activity After Surgery

• On the first post-operative day, patients typically spend an average of only 17 minutes walking 2
• By day 6 post-surgery, patients typically increase their walking time to approximately 53 minutes 2
• Lower post-operative activity levels are associated with longer hospital stays and delayed achievement of independent mobility 2

Factors Affecting Length of Stay

Several factors can influence the length of hospital stay after lumbar disc surgery:

• Type of procedure (fusion procedures generally require longer stays than simple discectomy) 1
• Patient age and comorbidities 1
• Presence of post-operative complications 2
• Pain control requirements 1
• Ability to ambulate independently 2

Discharge Instructions and Follow-up

Upon discharge, patients should receive:

• Verbal and written instructions regarding post-operative care 1
• Advice to avoid driving, operating machinery, or consuming alcohol for at least 24 hours after general anesthesia 1
• Appropriate analgesics with clear instructions for their use 1
• Information about warning signs of possible complications and where to seek help 1
• A discharge summary for their primary care provider 1

Return to Work Considerations

Return to work timing varies based on the procedure type and patient occupation:

• For patients who undergo discectomy alone, return to work typically occurs around 12 weeks post-surgery 1
• For patients who undergo discectomy with fusion/plating, return to work typically occurs around 25 weeks post-surgery 1
• Manual laborers and those with physically demanding jobs may require longer recovery periods before returning to full duties 1

Early Rehabilitation

• Early physical therapy intervention after lumbar disc surgery has shown benefits in terms of pain reduction and functional improvement without increasing complications 3
• There is strong evidence that intensive exercise programs starting 4-6 weeks post-surgery improve functional status and lead to faster return to work compared to mild exercise programs 4
• There is no evidence that patients need to have their activities restricted after first-time lumbar disc surgery 4

Potential Complications and Readmissions

• The overall 30-day readmission rate after lumbar discectomy is approximately 2.6% 5
• The most common reasons for readmission are surgical site infections (24.4% of readmissions), pain issues (16.7%), and thromboembolic events (8.1%) 5
• The average time to readmission is 13 days post-surgery 5

Special Considerations

• Elderly patients may experience mild post-operative confusion, which is usually insignificant and should not delay discharge if social circumstances permit 1
• Protocols should exist for managing patients who require unscheduled admission, especially in stand-alone surgical units 1
• Best practice includes providing a helpline for the first 24 hours after discharge and telephone follow-up the next day 1