Investigating the weekend effect in decompressive thoracolumbar hemilaminectomy for acute intervertebral disc extrusion: An observational cohort study of 460 cases (2018–2023)

Abstract

ObjectiveTo investigate if weekend surgery is associated with poorer outcomes in dogs with acute thoracolumbar intervertebral disc extrusion (IVDE) undergoing decompressive thoracolumbar hemilaminectomy.Study designRetrospective observational cohort study.Sample populationA total of 460 consecutive cases were reviewed, with 401 dogs undergoing weekday surgery (Cohort WD), and 59 dogs undergoing weekend surgery (Cohort WE).MethodsMedical records of a surgical referral center in the UK were reviewed. Preoperative patient demographic and clinical data, and postoperative outcome data were collected with a minimum 28‐day follow‐up period. Multivariable logistic regression analysis was used to model the odds of a negative outcome.ResultsCohort WE had a higher preoperative proportion of nonambulatory dogs (p = .0115) but there were no significant differences between the nonambulatory (p = .3762) and deep‐pain negative subgroups (p = .6199). Cohort WE had a higher risk of not recovering ambulation compared to Cohort WD [79.2% vs. 91.6% recovery; adjusted OR 3.010 (95% CI: 1.259–7.190); p = .0132] and had a higher risk of postoperative morbidity [32.2% vs. 17.2%; adjusted OR 2.015 (95% CI: 1.089–3.729); p = .0257]. There were no significant differences in other outcome measures between cohorts.ConclusionWeekend surgery in canine decompressive thoracolumbar hemilaminectomy may be associated with poorer patient outcomes, specifically higher postoperative morbidity and a poorer rate of recovery of ambulation.Clinical significanceThis study demonstrates a weekend effect in veterinary surgery, which may be important in surgical decision‐making in acute thoracolumbar IVDE. Further scrutiny of the patient's journey through the veterinary healthcare system is warranted.