Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, CA.
Spine (Phila Pa 1976). 2024 Sep 1;49(17):E272-E278. doi: 10.1097/BRS.0000000000004958. Epub 2024 Feb 13.
Retrospective cohort study.
Characterize physical therapy (PT) utilization following single-level posterior lumbar fusion (PLF).
PLF is a common procedure that is increasing in frequency. After such surgeries, PT may be considered to facilitate mobilization and return to activities. However, the usage of such therapy has not been well-characterized in the literature.
Patients undergoing single-level PLF were identified from the 2010 to 2021 PearlDiver administrative database. These patients were stratified based on usage of therapy, home versus outpatient therapy, and timing of therapy within the year after surgery. To determine predictors of therapy, patient characteristics were determined and multivariable regressions were performed.
A total of 213,240 patients undergoing single-level PLF were identified, of which therapy was done in the year after surgery for 63,231 (29.0%, of which home therapy accounted for 16.5% of therapy visits). Of those who utilized PT, the average number of visits was 10.6±10.6. Home therapy peaked within the first month after surgery and outpatient therapy peaked at month two. Factors associated with any PT following PLF in decreasing odds ratio (OR) were having commercial insurance (OR: 1.68), being from the Northeast (OR: 1.41), age (OR: 1.13 for 70+ of age) female sex (OR: 1.09), and ECI (OR: 1.04 per point) ( P <0.001 for all). Of those who received therapy, factors associated with home PT utilization were being from the Northeast (OR: 2.55), age (OR: 1.91 for 70+ of age), Medicaid insurance (OR: 1.48), female sex (OR: 1.39), and interbody fusion (OR:1.07) ( P <0.001 for all).
After single-level PLF, the minority of patients received home or outpatient PT. Of those who did, there was significant variation in the number of visits, with nonmedical factors such as insurance plan and geographic region being strongly associated suggesting room for more consistent practice patterns.
Level 3.
回顾性队列研究。
描述单节段后路腰椎融合术（PLF）后的物理治疗（PT）利用情况。
PLF 是一种常见的手术，其频率正在增加。在这种手术后，可能会考虑使用 PT 来促进活动和恢复活动。然而，这种治疗的使用情况在文献中尚未得到很好的描述。
从 2010 年至 2021 年的 PearlDiver 行政数据库中确定了接受单节段 PLF 的患者。根据治疗的使用情况、家庭治疗与门诊治疗以及术后一年内治疗的时间，对这些患者进行分层。为了确定治疗的预测因素，确定了患者特征并进行了多变量回归。
共确定了 213240 例接受单节段 PLF 的患者，其中 63231 例（29.0%）在术后一年内接受了治疗，其中家庭治疗占治疗就诊次数的 16.5%。在接受 PT 的患者中，平均就诊次数为 10.6±10.6。家庭治疗在术后第一个月达到高峰，门诊治疗在术后第二个月达到高峰。与 PLF 后任何 PT 相关的因素按降序排列的优势比（OR）为：商业保险（OR：1.68）、来自东北部（OR：1.41）、年龄（OR：70 岁以上为 1.13）、女性（OR：1.09）和 ECI（OR：每点 1.04）（所有 P<0.001）。在接受治疗的患者中，与家庭 PT 使用率相关的因素为：来自东北部（OR：2.55）、年龄（OR：70 岁以上为 1.91）、医疗补助保险（OR：1.48）、女性（OR：1.39）和椎间融合（OR：1.07）（所有 P<0.001）。
在接受单节段 PLF 后，少数患者接受家庭或门诊 PT。在接受治疗的患者中，就诊次数存在显著差异，非医疗因素，如保险计划和地理位置与就诊次数密切相关，这表明需要更一致的治疗模式。
3 级。
