Abstract
ObjectiveTo explore the association between preoperative physical performance with short- and long-term postoperative outcomes in patients undergoing lumbar spinal fusion (LSF). DesignRetrospective cohort. SettingUniversity hospital. ParticipantsSeventy-seven patients (N=77) undergoing elective LSF were preoperatively screened on patient demographics, patient-reported outcome measures, and physical performance measures (movement control, back muscle endurance strength and extensor strength, aerobic capacity, flexibility). InterventionsNot applicable. Main Outcome MeasuresAssociations between preoperative variables and inpatient functional recovery, hospital length of stay (LOS), and 1- to 2-year postoperative pain reduction were explored using random forest analyses assessing the relative influence of the variable on the outcome. ResultsAerobic capacity was associated with fast functional recovery <4 days and prolonged functional recovery >5 days (median z scores=7.1 and 12.0). Flexibility (median z score=4.3) and back muscle endurance strength (median z score=7.8) were associated with fast functional recovery <4 days. Maximum back extensor strength was associated with prolonged functional recovery >5 days (median z score=8.6). Flexibility (median z score=5.1) and back muscle endurance strength (median z score=13.5) were associated with short LOS <5 days. Aerobic capacity (median z score=8.7) was associated with prolonged LOS >7 days. Maximum back extensor strength (median z score=3.8) was associated with 1- to 2-year postoperative pain reduction and aerobic capacity (median z score=2.8) was tentative. ConclusionsPhysical performance measures were associated with both short- and long-term outcomes after LSF. Adding these measures to prediction models predicting outcomes after LSF may increase their accuracy.
Highlights
The aim of this study is to explore associations of preoperative physical performance measures with postoperative short- and long-term outcomes in adult patients undergoing lumbar spinal fusion (LSF)
The cutoff points identified for short and prolonged length of stay (LOS) were discharge within 5 days and discharge in 7 days or more
This study explored the associations between preoperative physical performance and inpatient functional recovery, LOS, and a clinically relevant reduction in predominant pain 1-2 years after surgery in adult patients opting for elective 1- to 3-level LSF
Summary
This retrospective cohort study used data collected between January 2017 and September 2018 from a single university medical center. As part of standard care, all adult patients (aged ≥18 years) with a degenerative disorder of the lumbar spine and scheduled for elective 1- to 3-level LSF underwent a preoperative screening to measure their physical performance. Primary surgical indications included were spondylolisthesis, degenerative disk disease, prior spine surgery (ie, previous spinal fusion, discectomy, laminectomy). Patients eligible for elective LSF had previously received at least 1 type of conservative treatment (eg, physiotherapy, pain medication, nerve block) that was not effective in relieving their complaints. List of abbreviations: LOS length of stay LSF lumbar spinal fusion mILAS modified Iowa Level of Assistance Scale PCS Pain Catastrophizing Scale VAS visual analog scale prior to surgery. A trained hospital physical therapist executed the screenings between January 2017 and July 2018
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
