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Impact of Weekday on Short-term Surgical Outcomes After Lumbar Fusion Surgery – Lumbar Fusion

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A retrospective cohort study investigated the impact of weekday lumbar spine fusion surgery on surgical and inpatient physical therapy outcomes. The study found that patients undergoing surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. However, there was no adverse effect of later weekday surgery on total complications, readmissions, and reoperations. Patients in the late surgery subgroup achieved a farther total gait distance compared to those in the early surgery subgroup. This study provides valuable insights into the timing of spine surgery and its effects on patient outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

S: Patients who undergo surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. This analysis showed no adverse effect of later weekday surgery as it relates to total complications, readmissions, and reoperations.

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Clin Spine Surg. 2024 Mar 12. doi: 10.1097/BSD.0000000000001605. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes.SUMMARY OF BACKGROUND DATA: Timing of surgery has been implicated as a factor that may,

Clin Spine Surg. 2024 Mar 12. doi: 10.1097/BSD.0000000000001605. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes.

SUMMARY OF BACKGROUND DATA: Timing of surgery has been implicated as a factor that may impact outcomes after spine surgery. Previous literature suggests that there may be an adverse effect to having surgery on the weekend.

METHODS: All patients ≥18 years who underwent primary lumbar spinal fusion from 2014 to 2020 were retrospectively identified. Patients were subdivided into an early subgroup (surgery between Monday and Wednesday) and a late subgroup (surgery between Thursday and Friday). Surgical outcome variables included inpatient complications, 90-day readmissions, and 1-year revisions. PT data from the first inpatient PT session included hours to PT session, AM-PAC Daily Activity or Basic Mobility scores, and total gait trial distance achieved.

RESULTS: Of the 1239 patients identified, 839 had surgery between Monday and Wednesday and 400 had surgery between Thursday and Friday. Patients in the later surgery subgroup were more likely to experience a nonsurgical neurologic complication (3.08% vs. 0.86%, P=0.008); however, there was no difference in total complications. Patients in the early surgery subgroup had their first inpatient PT session earlier than patients in the late subgroup (15.7 vs. 18.9 h, P<0.001). However, patients in the late subgroup achieved a farther total gait distance (98.2 vs. 75.4, P=0.011). Late surgery was a significant predictor of more hours of PT (est.=0.256, P=0.016) and longer length of stay (est.=2.277, P=0.001). There were no significant differences in readmission and revision rates.

S: Patients who undergo surgery later in the week may experience more nonsurgical neurologic complications, longer wait times for inpatient PT appointments, and longer lengths of stay. This analysis showed no adverse effect of later weekday surgery as it relates to total complications, readmissions, and reoperations.

LEVEL OF EVIDENCE: Level III.

PMID:38490974 | DOI:10.1097/BSD.0000000000001605

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Impact of Weekday on Short-term Surgical Outcomes After Lumbar Fusion Surgery

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Clin Spine Surg. 2024 Mar 12. doi: 10.1097/BSD.0000000000001605. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: The purpose of this study is to investigate whether weekday lumbar spine fusion surgery has an impact on surgical and inpatient physical therapy (PT) outcomes.SUMMARY OF BACKGROUND DATA: Timing of surgery has been implicated as a factor that may

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