Multidisciplinary Team-Based Perioperative Care in Patients Undergoing Oblique Lumbar Interbody Fusion: Assessing Safety and Surgical Stress in Lumbar Degeneration.

AIM: This study aims to explore the effectiveness of the multidisciplinary team (MDT)-based perioperative care model in the surgical safety and stress response of patients undergoing oblique lumbar interbody fusion (OLIF) for lumbar degeneration (LDD), to provide an evidence-based reference to optimizing the nursing strategy during minimally invasive spine surgery.

METHODS: This retrospective cohort analysis included 100 LDD patients who received OLIF in Beijing Tongren Hospital, Capital Medical University between May 2023 and March 2025. Patients were divided into two groups based on the nursing model: an MDT group (n = 51) and a conventional group (n = 49). The MDT group received an integrated, MDT-based care provided by a team of experienced surgeons, anesthesiologists, rehabilitation experts, nutritionists, and psychologists. The conventional group received traditional single-discipline nursing care. The primary outcome measures included: length of hospital stay (cumulative time from admission to discharge); perioperative safety outcomes (operative time, intraoperative blood loss, and complication rates); physiological and psychological stress responses, including C-reactive protein (CRP), cortisol levels, visual analogy scale (VAS) pain scores, Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI) scores; nursing quality (patient compliance and satisfaction); and short-term imaging indicators such as the 3-month lumbar fusion rate, oswestry disability index (ODI) scores, and the incidence of adjacent segment disease (ASD).

RESULTS: Compared with the conventional group, the MDT group had significantly shorter operation time and less intraoperative blood loss (p < 0.05). However, there was no difference in the length of postoperative hospital stays between the two groups (p > 0.05). The incidence of postoperative complications was significantly lower in the MDT group than in the conventional group (13.72% vs. 28.57%, p = 0.036). At postoperative days 1, 3, and 7, the MDT group had substantially lower CRP and Cortisol (Cor) levels than the conventional group (p < 0.05). Furthermore, at postoperative days 1 and 3, the MDT care group showed lower VAS and GAD-7 scores (p < 0.05). The PSQI was also lower in the MDT group at postoperative days 3 and 7 (p < 0.05). In terms of nursing quality, the team nursing compliance (TNC) rate and Nurse-Patient Communication Efficacy (NPCE) were higher in the MDT group than the conventional group (p < 0.05), along with a lower non-compliance rate (11.76% vs. 30.61%, p = 0.021). Finally, patients in the MDT group reported greater nursing satisfaction than the conventional group (88.24% vs. 71.43%, p = 0.036). The follow-up results showed that there was no difference in ASD between the two groups (p > 0.05), but the lumbar fusion rate was higher and ODI was lower in the MDT group (p < 0.05).

CONCLUSIONS: In patients with lumbar degenerative diseases undergoing OLIF surgery, perioperative management based on a MDT was associated with improved short-term perioperative outcomes, including reduced surgical stress indicators, decreased postoperative pain and anxiety levels, and lower complication rates. These findings suggested that MDT-based management may be a feasible perioperative management strategy for OLIF, but further prospective studies with longer follow-up were needed.