Document Type
Article
Publication Date
9-18-2023
Abstract
OBJECTIVES: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.
METHODS: Patients >18 years of age who underwent primary one‑ or two‑level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all‑cause 90 days readmissions and 90 days surgical readmissions), and patient‑reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1‑year postoperative point. Alpha was set at P < 0.05.
RESULTS: Of the 1003 patients included, 421 attended PT postoperatively. On univariate analysis, PT attendance did not significantly impact 90‑day surgical reoperations (P = 0.225). Although bivariate analysis suggests that attendance of PT is associated with worse improvement in physical function (P = 0.041), increased preoperative Visual Analogue Scale leg pain (0 = 0.004), and disability (P = 0.006), as measured by the Oswestry Disability Index, our multivariate analysis, which accounts for confounding variables found there was no difference in PROM improvement and PT was not an independent predictor of 90‑day all‑cause readmissions (P = 0.06). Instead, Charlson Comorbidity Index (P = 0.025) and discharge to a skilled nursing facility (P = 0.013) independently predicted greater 90‑day all‑cause readmissions.
CONCLUSIONS: Postoperative lumbar decompression PT attendance does not significantly affect clinical improvement, as measured by PROMs or surgical outcomes including all-cause 90 days readmissions and 90-day surgical readmissions.
Recommended Citation
Heard, Jeremy C.; D'Antonio, Nicholas D.; Lambrechts, Mark J.; Boere, Payton; Issa, Tariq Z.; Lee, Yunsoo A.; Canseco, Jose A.; Kaye, Ian David; Woods, Barrett R.; Hilibrand, Alan S.; Vaccaro, Alexander R.; Kepler, Christopher K.; and Schroeder, Gregory D., "Does Physical Therapy Impact Clinical Outcomes After Lumbar Decompression Surgery?" (2023). Rothman Institute Faculty Papers. Paper 251.
https://jdc.jefferson.edu/rothman_institute/251
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.
Language
English
Comments
This article is the author's final published version in the Journal of Craniovertebral Junction and Spine, Volume 14, Issue 3, Jul-Sept 2023, Pg. 230 - 235.
The published version is available at https://doi.org/10.4103/jcvjs.jcvjs_61_23. Copyright © 2023 Journal of Craniovertebral Junction and Spine | Published by Wolters Kluwer ‑ Medknow.