Day Case Lumbar Fusion Surgery
This article is a retrospective cohort study that aimed to determine if outcomes varied among patients based on their attendance of physical therapy (PT) after lumbar fusion surgery. The study found that there was no significant difference in patient-reported outcome measures (PROMs) between patients who attended PT and those who did not. Patients who attended PT had longer operative durations, longer postoperative hospital stays, and more fused levels, but there were no significant differences in readmission, complication, and revision rates. The data suggest that PT does not significantly impact PROMs after lumbar fusion surgery, and surgeons should consider more strict criteria when recommending PT to their patients. The study is categorized as Level-III evidence
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced spine centre in the world
Published article
CONCLUSION: Our data suggest that physical therapy does not significantly impact PROMs after lumbar fusion surgery. Given the lack of data suggesting clear benefit of PT after lumbar fusion, surgeons should consider more strict criteria when recommending physical therapy to their patients after lumbar fusion surgery.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Clin Spine Surg. 2023 Jul 24. doi: 10.1097/BSD.0000000000001483. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective Cohort.OBJECTIVE: To determine if outcomes varied between patients based on physical therapy (PT) attendance after lumbar fusion surgery.SUMMARY OF BACKGROUND DATA: The literature has been mixed regarding the efficacy of postoperative PT to improve disability and back pain, as measured by,
Clin Spine Surg. 2023 Jul 24. doi: 10.1097/BSD.0000000000001483. Online ahead of print.
ABSTRACT
STUDY DESIGN: Retrospective Cohort.
OBJECTIVE: To determine if outcomes varied between patients based on physical therapy (PT) attendance after lumbar fusion surgery.
SUMMARY OF BACKGROUND DATA: The literature has been mixed regarding the efficacy of postoperative PT to improve disability and back pain, as measured by patient-reported outcome measures. Given the prevalence of PT referrals and lack of high-quality evidence, there is a need for additional studies investigating the efficacy of PT after lumbar fusion surgery to aid in developing robust clinical guidelines.
METHODS: We retrospectively identified patients receiving lumbar fusion surgery by current procedural terminology codes and separated them into 2 groups based on whether PT was prescribed. Electronic medical records were reviewed for patient and surgical characteristics, PT utilization, and surgical outcomes. Patient-reported outcome measures (PROMs) were identified and compared preoperatively, at 90 days postoperatively and one year postoperatively.
RESULTS: The two groups had similar patient characteristics and comorbidities and demonstrated no significant differences between readmission, complication, and revision rates after surgery. Patients that attended PT had significantly more fused levels (1.41 ± 0.64 vs. 1.32 ± 0.54, P=0.027), longer operative durations (234 ± 96.4 vs. 215 ± 86.1 min, P=0.012), and longer postoperative hospital stays (3.35 ± 1.68 vs. 3.00 ± 1.49 days, P=0.004). All groups improved similarly by Oswestry Disability Index, short form-12 physical and mental health subsets, and back and leg pain by Visual Analog Scale at 90-day and 1-year follow-up.
CONCLUSION: Our data suggest that physical therapy does not significantly impact PROMs after lumbar fusion surgery. Given the lack of data suggesting clear benefit of PT after lumbar fusion, surgeons should consider more strict criteria when recommending physical therapy to their patients after lumbar fusion surgery.
LEVEL OF EVIDENCE: Level-Ⅲ.
PMID:37491717 | DOI:10.1097/BSD.0000000000001483
The London Spine Unit : most experienced spine centre in the world
Read the original publication:
The Impact of Physical Therapy After Lumbar Fusion Surgery
