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The Impact of Physical Therapy After Lumbar Fusion Surgery.
Heard, Jeremy C; Lee, Yunsoo A; Lambrechts, Mark; Brush, Parker; Issa, Tariq Z; Kanhere, Arun; Bodner, John; Purtill, Caroline; Reddy, Yashas C; Patil, Sanath; Somers, Sydney; D'Antonio, Nicholas D; Mangan, John J; Canseco, Jose A; Woods, Barrett R; Kaye, Ian D; Rihn, Jeff A; Hilibrand, Alan S; Vaccaro, Alexander R; Kepler, Christopher K; Schroeder, Gregory D.
Afiliação
  • Heard JC; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Lee YA; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Lambrechts M; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Brush P; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Issa TZ; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Kanhere A; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Bodner J; Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Purtill C; Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Reddy YC; Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Patil S; Sydney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Somers S; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • D'Antonio ND; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Mangan JJ; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Canseco JA; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Woods BR; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Kaye ID; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Rihn JA; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Hilibrand AS; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Vaccaro AR; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Kepler CK; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
  • Schroeder GD; Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA.
Clin Spine Surg ; 36(10): 419-425, 2023 12 01.
Article em En | MEDLINE | ID: mdl-37491717
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.
Assuntos

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Fusão Vertebral / Dor nas Costas Tipo de estudo: Guideline / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Clin Spine Surg Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Panamá

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Fusão Vertebral / Dor nas Costas Tipo de estudo: Guideline / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Clin Spine Surg Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Panamá