Shinn Daniel, Mok Jung Kee, Vaishnav Avani S, Louie Philip K, Sivaganesan Ahilan, Shahi Pratyush, Dalal Sidhant, Song Junho, Araghi Kasra, Melissaridou Dimitra, Sheha Evan D, Sandhu Harvinder S, Dowdell James E, Iyer Sravisht, Qureshi Sheeraz A
Weill Cornell Medical College, New York, NY.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY.
Spine (Phila Pa 1976). 2022 Nov 1;47(21):1489-1496. doi: 10.1097/BRS.0000000000004399. Epub 2022 Jul 15.
Single-center, multisurgeon, retrospective review.
To evaluate the timing of return to commonly performed activities following minimally invasive spine surgery. Identify preoperative factors associated with these outcomes.
Studies have reported return to activities with open techniques, but the precise timing of when patients return to these activities after minimally invasive surgery remains uncertain.
Patients who underwent either minimally invasive lumbar laminectomy (MI-L) or minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) were included. Patient-reported outcome measures, return to drive, return to work, and discontinuation of opioids data were reviewed. Regression was conducted to identify factors associated with return to driving by 15 days, return to work by 30 days, and for discontinuing opioids by 15 days. A composite group analysis was also performed for patients who returned to all three activities by 30 days.
In total, 123 MI-L patients and 107 MI-TLIF patients were included. Overall, 88.8% of MI-L patients and 96.4% of MI-TLIF patients returned to driving in 11 and 18.5 days, respectively. In all, 91.9% of MI-L patients and 85.7% of MI-TLIF patients returned to work in 14 and 25 days. In all, 88.7% of MI-L patients and 92.6% of MI-TLIF patients discontinued opioids in a median of seven and 11 days. Overall, 96.2% of MI-L patients and 100% of MI-TLIF patients returned to all three activities, with a median of 27 and 31 days, respectively. Male sex [odds ratio (OR)=3.57] and preoperative 12-Item Short Form Physical Component Score (OR=1.08) are associated with return to driving by 15 days. Male sex (OR=3.23) and preoperative 12-Item Short Form Physical Component Score (OR=1.07) are associated with return to work by 30 days. Preoperative Visual Analog Scale back was associated with decreased odds of discontinuing opioids by 15 days (OR=0.84).
Most patients return to activity following MI-L and MI-TLIF. These findings serve as an important compass for preoperative counseling.
单中心、多外科医生的回顾性研究。
评估微创脊柱手术后恢复常见活动的时间。确定与这些结果相关的术前因素。
已有研究报道了采用开放技术恢复活动的情况，但微创手术后患者恢复这些活动的确切时间仍不确定。
纳入接受微创腰椎椎板切除术（MI-L）或微创经椎间孔腰椎椎间融合术（MI-TLIF）的患者。回顾患者报告的结局指标、恢复驾驶、恢复工作和停用阿片类药物的数据。进行回归分析以确定与术后15天恢复驾驶、30天恢复工作以及15天停用阿片类药物相关的因素。还对在30天内恢复所有三项活动的患者进行了综合组分析。
共纳入123例MI-L患者和107例MI-TLIF患者。总体而言，88.8%的MI-L患者和96.4%的MI-TLIF患者分别在11天和18.5天恢复驾驶。总共，91.9%的MI-L患者和85.7%的MI-TLIF患者分别在14天和25天恢复工作。总共，88.7%的MI-L患者和92.6%的MI-TLIF患者分别在中位时间7天和11天停用阿片类药物。总体而言，96.2%的MI-L患者和100%的MI-TLIF患者恢复了所有三项活动，中位时间分别为27天和31天。男性[比值比（OR）=3.57]和术前12项简短健康调查身体成分评分（OR=1.08）与术后15天恢复驾驶相关。男性（OR=3.23）和术前12项简短健康调查身体成分评分（OR=1.07）与术后30天恢复工作相关。术前视觉模拟量表背部评分与术后15天停用阿片类药物几率降低相关（OR=0.84）。
大多数患者在MI-L和MI-TLIF术后恢复活动。这些发现为术前咨询提供了重要指导。
