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Physical Therapy Utilization Following Single Level Posterior Lumbar Fusion – Lumbar Fusion

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This article is a retrospective cohort study that aims to characterize the utilization of physical therapy (PT) following single-level posterior lumbar fusion (PLF) surgeries. The study found that a minority of patients received home or outpatient PT after the surgery, and there was significant variation in the number of visits. Nonmedical factors such as insurance plan and geographic region were strongly associated with PT utilization, suggesting the need for more consistent practice patterns. The study concludes that there is room for improvement in the utilization of PT following PLF surgeries

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Published article

S: Following single-level PLF, the minority of patients received home or outpatient PT. Of those that did, there was significant variation in the number of visits, with nonmedical factors such as insurance plan and geographic region being strongly associated suggesting room for more consistent practice patterns.

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Spine (Phila Pa 1976). 2024 Feb 13. doi: 10.1097/BRS.0000000000004958. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF).SUMMARY OF BACKGROUND DATA: PLF is a common procedure that is increasing in frequency. Following such surgeries, PT may be considered to facilitate mobilization and return to activities.,

Spine (Phila Pa 1976). 2024 Feb 13. doi: 10.1097/BRS.0000000000004958. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF).

SUMMARY OF BACKGROUND DATA: PLF is a common procedure that is increasing in frequency. Following such surgeries, PT may be considered to facilitate mobilization and return to activities. However, the usage of such therapy has not been well-characterized in the literature.

METHODS: Patients undergoing single-level PLF were identified from the 2010-2021 PearlDiver administrative database. These patients were stratified based on usage of therapy, home versus outpatient therapy, and timing of therapy within the year following surgery. To determine predictors of therapy, patient characteristics were determined and multivariable regressions were performed.

RESULTS: A total of 213,240 patients undergoing single-level PLF were identified, of which therapy was done in the year following surgery for 63,231 (29.0%, of which home therapy accounted for 16.5% of therapy visits). Of those who utilized PT, the average number of visits was 10.6±10.6. Home therapy peaked within the first month following surgery and outpatient therapy peaked at month two. Factors associated with any PT following PLF in decreasing odds ratio (OR) were: having commercial insurance (OR: 1.68), being from the Northeast (OR:1.41), age (OR: 1.13 for 70+ of age) female sex (OR: 1.09), and ECI (OR: 1.04 per point) (P<0.001 for all). Of those who received therapy, factors associated with home PT utilization were: being from the Northeast (OR: 2.55), age (OR: 1.91 for 70+ of age), Medicaid insurance (OR: 1.48), female sex (OR: 1.39), and interbody fusion (OR:1.07) (P<0.001 for all).

S: Following single-level PLF, the minority of patients received home or outpatient PT. Of those that did, there was significant variation in the number of visits, with nonmedical factors such as insurance plan and geographic region being strongly associated suggesting room for more consistent practice patterns.

LEVEL OF EVIDENCE: III.

PMID:38349019 | DOI:10.1097/BRS.0000000000004958

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Physical Therapy Utilization Following Single Level Posterior Lumbar Fusion

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Spine (Phila Pa 1976). 2024 Feb 13. doi: 10.1097/BRS.0000000000004958. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF).SUMMARY OF BACKGROUND DATA: PLF is a common procedure that is increasing in frequency. Following such surgeries, PT may be considered to facilitate mobilization and return to activities.

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