225 SpineTrak: The First Randomized Controlled Trial Using the Apple Watch to Objectively Track Spine Surgical Patients

Abstract

INTRODUCTION: Early mobilization after surgery is associated with reduced complications, shorter hospitalization, and improved psychological well-being. Current methods for evaluating spine surgery outcomes rely on subjective, patient-reported outcome measures (PROMs). Wearable activity monitors, including the Apple Watch (AW), allow for real-time tracking of objective activity metrics. METHODS: Eligibility: Adult patients undergoing elective spine surgery. Patients are randomized 1:1 to the intervention vs control group. All patients complete PROMs pre-operatively and at 6-weeks, 3-months, 6-months, and 1-year post-operatively. Only intervention patients receive AW and download a study-specific app to collect AW data. AW health measures are visualized in reports provided to patients and surgeons. RESULTS: To date, we have enrolled 200 patients (n=100 intervention; n=100 control). Among patients past 1-year post-operation (n=129), 74% reached the minimal clinically-important difference in improvement for ODI/NDI, SF-36 PCS, and/or EQ-VAS relative to pre-operation. Intervention patients (n=95) have worn AW 81.3%±21.1% of the days for 14.6±4.7 hours/day. At 6-weeks post-operation, 73% of patients responded that they were very satisfied with using the AW in their spine care. 61% found seeing their AW activity data helpful. 96% of neurosurgeons agreed that AW reports help them understand their patients’ recovery. Preliminary analyses of patient recovery profiles have predicted the requirement for revision surgery in some participants. CONCLUSIONS: Preliminary results indicate patients are compliant with wearing the AW, and both patients and surgeons are satisfied with its use in their spine care. Initial analyses show poor correlation between AW measures and PROMs, emphasizing the need for a metric that combines objective and subjective measures to better track spine surgery recovery.