The Impact of Physical Therapy After Lumbar Fusion Surgery.
Publication/Presentation Date
12-1-2023
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.
Volume
36
Issue
10
First Page
419
Last Page
425
ISSN
2380-0194
Published In/Presented At
Heard, J. C., Lee, Y. A., Lambrechts, M., Brush, P., Issa, T. Z., Kanhere, A., Bodner, J., Purtill, C., Reddy, Y. C., Patil, S., Somers, S., D'Antonio, N. D., Mangan, J. J., Canseco, J. A., Woods, B. R., Kaye, I. D., Rihn, J. A., Hilibrand, A. S., Vaccaro, A. R., Kepler, C. K., … Schroeder, G. D. (2023). The Impact of Physical Therapy After Lumbar Fusion Surgery. Clinical spine surgery, 36(10), 419–425. https://doi.org/10.1097/BSD.0000000000001483
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
37491717
Department(s)
Administration and Leadership
Document Type
Article