Ma Alison, Mobbs Ralph J, Maharaj Monish M
Faculty of Medicine, University of New South Wales, Sydney NSW, Australia
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Randwick NSW, Australia.
Int J Spine Surg. 2025 Mar 6;19(1):39-48. doi: 10.14444/8718.
There has been a gradual shift from open spine surgery to minimally invasive techniques such as endoscopic spine surgery to reduce approach-related trauma, collateral damage, and complications. While recovery following surgery has been measured using subjective measures including patient-reported outcome measures, the introduction of smart wearable devices now provides both an objective and continuous method of patient assessment. This prospective study compares patient recovery after uniportal endoscopic and open lumbar spine surgery by analyzing mobility and gait metrics captured by a wearable sensor.
Participants included 24 patients who underwent a single-level uniportal endoscopic lumbar decompression or open posterior lumbar fusion. During the first 48 hours after surgery, patients wore a sensor that continuously monitored position, step count, and gait metrics.
In the immediate postoperative period, endoscopic spine surgery patients experienced a quicker return to mobility, with less time lying down, higher step count, faster gait velocity, lower double support percentage, and reduced variability, compared with open spine surgery patients.
There are key differences in patient mobility and gait following uniportal endoscopic and open spine surgery. Endoscopic spine surgery patients had faster recovery, which can guide resource allocation toward the development of training programs and support the advancement of spine endoscopy to address a broader range of pathologies. This pilot study highlights the potential for wearable devices to be used in further studies to form spine surgery recovery trajectories, allowing targeted rehabilitation and prompt intervention for deviations in patient recovery.
This study demonstrates the benefits of endoscopic spine surgery for improved postoperative recovery in terms of mobility and gait metrics. Additionally, it highlights the potential for wearable sensor technology to provide an objective and continuous method for assessing postoperative outcomes and for the development of individualized rehabilitation protocols. These findings support the broader adoption of endoscopic techniques and emphasize the value of incorporating wearable devices into postoperative monitoring to optimize patient care.
脊柱手术已逐渐从开放手术转向微创技术，如内镜脊柱手术，以减少手术相关创伤、附带损伤和并发症。虽然术后恢复情况一直通过主观指标进行衡量，包括患者报告的结局指标，但智能可穿戴设备的出现现在提供了一种客观且连续的患者评估方法。这项前瞻性研究通过分析可穿戴传感器捕获的移动性和步态指标，比较了单孔内镜和开放腰椎手术后患者的恢复情况。
参与者包括24例接受单节段单孔内镜腰椎减压或开放后路腰椎融合术的患者。在手术后的头48小时内，患者佩戴一个传感器，该传感器持续监测位置、步数和步态指标。
与开放脊柱手术患者相比，内镜脊柱手术患者在术后即刻恢复移动性更快，躺卧时间更少，步数更多，步态速度更快，双支撑百分比更低，变异性更小。
单孔内镜和开放脊柱手术后患者的移动性和步态存在关键差异。内镜脊柱手术患者恢复更快，这可以指导资源分配用于培训项目的开发，并支持脊柱内镜技术的进步以应对更广泛的病理情况。这项初步研究强调了可穿戴设备在进一步研究中用于形成脊柱手术恢复轨迹的潜力，从而允许针对患者恢复偏差进行有针对性的康复和及时干预。
本研究证明了内镜脊柱手术在改善术后移动性和步态指标恢复方面的益处。此外，它强调了可穿戴传感器技术提供客观且连续的术后结局评估方法以及开发个性化康复方案的潜力。这些发现支持更广泛地采用内镜技术，并强调将可穿戴设备纳入术后监测以优化患者护理的价值。
