Abstract
Studies on driving safety after lumbar spinal procedures are rare. Previous studies solely reported on a) driving reaction time (DRT) after lumbar nerve root blocks, b) DRT after discectomy and c) preliminary DRT findings after lumbar fusion. DRT was assessed with a driving simulator as described before. Measurements were done one day before surgery (preop DRT), one week after surgery (postop1 DRT), three months (postop2 DRT) and one year postoperatively (postop3 DRT). Back pain was determined with visual analogue scales (VAS) on all four occasions. Additionally, we monitored each patient's pre-operative driving frequency and intake of analgesics. For statistical analysis we used an ANOVA for repeated measurements. Thirt eight of 51 patients completed all measurements (17 monosegmental fusion, 14 polysegmental fusion, seven other lumbar fusion procedures). The longitudinal changes in DRT showed overall significance (p = 0.013). Post-hoc tests determined p = 0.035 for the DRT-increase from pre- to postoperative. We did not determine a significant statistical effect for the type of surgery (p = 0.581) or patient age (p = 0.134). A tendency towards statistical significance was ascertained for the influence of patients' driving frequency on DRT (p = 0.051). We found increased DRT at the time of discharge after lumbar spinal fusion and therefore recommend driving abstinence for the time thereafter. Based on our findings it appears safe to return to driving at 3months postoperative.
Highlights
Driving ability can be crucial for an individual’s participation in social life and for dealing with the daily to-dos
We found increased driving reaction time (DRT) at the time of discharge after lumbar spinal fusion and recommend driving abstinence for the time thereafter
International Orthopaedics (SICOT) (2016) 40:1261–1265 follow-up period, a small and inhomogeneous patient population and the inability to study the effect of different types of fusion surgery
Summary
A. The most important finding of our study was the postoperative increase of DRT 1 week after surgery. Thaler et al [13] reported on DRT in patients who underwent surgery for lumbar disc herniation and found no worsening of DRT at the time of discharge They did not recommend driving abstinence at all. Due to the limitations of that study we did not even find a statistical tendency for postoperative worsening of the DRT and recommended no driving abstinence after discharge. The current study assessed significant associations between VAS pain and DRT on several test dates These findings are partly contrasted [1] and partly supported by previous studies [10]. We found increased DRT at the time of discharge after lumbar spinal fusion and recommend driving abstinence for the time thereafter. These findings are applicable regardless of which type of spinal fusion was performed
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