Acute Physical Therapy and Length of Hospital Stay Following Lumbar Discectomy and Lumbar Fusion: A Retrospective Analysis

Abstract

Purpose: Lumbar fusion and discectomy are commonly performed spinal surgical procedures. Factors associated with post-surgical length of hospital stay (LOS) have not been investigated. The purpose of this study was to evaluate factors, including utilization of acute physical therapy intervention (APTI), that were associated with LOS following lumbar discectomy or fusion. Method: A retrospective medical record review was conducted for 100 patients who underwent lumbar discectomy or fusion between December 1, 2007 and December 1, 2009. We tested for correlations of APTI, patient and surgery characteristics with LOS. Results: Age, number of surgical levels, functional dependency and number of acute physical therapy visits all yielded significant bivariate correlation to LOS. The dichotomous variables, type of surgery, sex, and discharge placement level were related to significant differences in LOS. These variables were included in a linear regression model to test for unique contributions of variance of these factors to LOS. Follow-up analysis tested the unique contributions of APTI and functional dependency to variability in LOS. Conclusion: Increased LOS is associated with greater age, greater number of pathological levels, fusion, greater functional dependency, discharge status to a care facility, male sex, and more physical therapy visits. While this study design cannot distinguish the impact of APTI on LOS, it suggests factors that may guide identification of patients likely to have a longer LOS.