1. Lumbar Surgery Audit Period 1 st Jan 2007- 31 st Dec 2007 Presented at Britspine 2008 4 teaching Hospital consultants 2 District General Hospitals

2. Lumbar discetomy Audit 116 discetomy by 5 surgeons  4 incidental durotomy one psuedomenigocoele  3.48% Comparable to reported literature

3. The raw data by surgeon is given, the data does not permit analysis as different criteria have been used.

4. Lumbar discetomy Audit Surgeon 1 18 patients  Pre op ODI 55 post op 28  Pre op VAS 7.6 post 3.6  Follow up 11 of 18 61%

5. Lumbar discetomy Audit Surgeon 1 11 with FU of 18 patients Change in ODI

6. Lumbar Decompression Audit Surgeon 1  Open procedures for L4/L5 stenosis  age over 50  5 decompressions  19 interspinous distraction devices  Two incidental durotomy  Two spinous process fracture  3 listed for revision 1 revised

7. Lumbar Decompression Audit Surgeon 1  Pre op oswestry 45  Pre op walking 160  Pre op vas 7.58  Fu 13 out of 24  Oswestry 34  Walking 713  Vas 5.4

8. Surgeon 2 Surgeon 2 SINGLE LEVEL UNILATERAL PRIMARY DISCECTOMIES

9. SINGLE LEVEL UNILATERAL PRIMARY DISCECTOMIES Surgeon 2 Total number of spine operations – 43 Single level unilateral primary discectomies – 24 01/01/2007 to 31/12/2007

10. OSWESTRY DISABILITY INDEX * ( AVAILABLE FOR ALL PATIENTS ) Surgeon 2 Mean Pre operative score Mean Post operative score (6 weeks post- op) 30.0418.63 * Score out of 50

11. OSWESTRY DISABILITY INDEX Surgeon2 Mean Pre operativ e score Mean Post operative score ( 6 weeks post op ) Mean Post operative score ( 6 months post op ) 27.8616.2910.86

12. COMPLICATIONS Surgeon2 Infection / dural tear / DVT / bladder disturbances } Nil Leg weakness } 1 patient had post operative foot drop     resolved at clinic visit Recurrence 1

13. Surgeon3 01-04-07 to 30-09-07 Primary Lumbar Discectomy < 50 years

14. Surgeon3   Retrospective review of casenotes   Total Male 8 Female 6   Age 21- 30 3 31- 40 7 41- 50 4

15. Surgeon3   Type Bulge 1 Contained 8 Sequestered 1 Hard 3   Cauda equina 1

16. Surgeon3   Follow-up < 1 month 8 < 2 2 3 2 9 2   Results Good/ex 11 Moderate 2 Poor 1

17. Surgeon 4 27 microdiscectomies 1 late pseudomeningocele 1 wrong level diagnosis on CT (cauda equina)

18. Surgeon 5   23 microdisccetomies 1 L3/4 6 L4/5 16 L5/S1   Complications 1 significant epidural bleeding 1 temp urinary retention / quads weakness

19. Surgeon 6   27 microdiscectomies 1 cauda equina 14 L4/5 12 L5/S1   Complications 1 dural tear 1 recurrence – settled conservatively   Outcomes 10 pre-op & 6month post-op complete 9 pre-op only 8 no data

20. Results (n=10) Surgeon 6

21. Surgeons 4,5,6   77 microdiscectomies 6 complications   Poor collection of outcome data