Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria.
Eur Spine J. 2013 Jul;22(7):1517-21. doi: 10.1007/s00586-013-2688-6. Epub 2013 Mar 10.
Reduced driving reaction time (DRT) has already been studied in context with lumbar disc surgeries. Data on whether cervical spine pathologies impair driving abilities are still lacking. In addition, no return-to-driving recommendations after anterior cervical fusion procedures have been published. Therefore, we assessed DRT before and after anterior cervical discectomy and fusion.
We performed a prospective study with 12 patients (mean age 47.2 years; female 7, male 5). DRT as well as arm and neck pain were evaluated before surgery, on the day before discharge from hospital and at the 4-6-week follow-up examinations. 31 healthy subjects were tested for DRT as a control group.
All patients showed significant improvement in DRT in the longitudinal course (p < 0.05). DRT was 601 ms (median, IQR: 63) before surgery, which was reduced to 580 ms (median, IQR: 112) on the day before discharge from hospital and to 532 ms (median, IQR: 48) at follow-up examination. Control subjects had a driving reaction time of 487 ms (median, IQR: 116), which differed significantly from that of patients at all three testing times (p < 0.05). VAS for arm and neck pain showed significant improvement (p < 0.05).
The present results show a positive effect of anterior cervical discectomy and fusion on driving safety. Based on our data we state that it appears to be safe to resume driving after discharge from hospital. However, patients scheduled to undergo anterior cervical discectomy and fusion should be informed about increased DRT as compared to healthy individuals.
腰椎间盘手术相关研究已经探讨了驾驶反应时间(DRT)的缩短。目前仍缺乏颈椎病变是否会影响驾驶能力的数据。此外,颈椎前路融合术后的恢复驾驶建议尚未公布。因此,我们评估了颈椎前路椎间盘切除融合术前后的 DRT。
我们进行了一项前瞻性研究,共纳入 12 名患者(平均年龄 47.2 岁;女性 7 例,男性 5 例)。在术前、出院前 1 天和术后 4-6 周的随访中,评估了 DRT 以及手臂和颈部疼痛情况。31 名健康受试者作为对照组进行 DRT 测试。
所有患者在纵向研究中 DRT 均显著改善(p < 0.05)。术前 DRT 为 601ms(中位数,IQR:63),出院前 1 天降低至 580ms(中位数,IQR:112),术后 4-6 周随访时进一步降低至 532ms(中位数,IQR:48)。对照组的驾驶反应时间为 487ms(中位数,IQR:116),与所有三个测试时间点的患者相比均显著不同(p < 0.05)。手臂和颈部疼痛的 VAS 评分均显著改善(p < 0.05)。
本研究结果显示颈椎前路椎间盘切除融合术对驾驶安全具有积极影响。基于我们的数据,我们认为出院后恢复驾驶是安全的。然而,拟行颈椎前路椎间盘切除融合术的患者应被告知其 DRT 可能比健康个体延长。