Skip to main content
2024 AANS Annual Scientific Meeting Main banner
Back

Spine Rapid Fire Abstract

Spine

Physical Therapy Does Not Improve Patient-Reported Outcomes after Lumbar Fusion

Saturday, May 4, 2024
3:43 PM – 3:45 PM CT
Location:  S403ab
Disclosure(s):
Rajkishen Narayanan, MD: No financial relationships to disclose
Michael McCurdy, MD: No financial relationships to disclose
Introduction: Episode-of-care (EOC) costs in spine are multifactorial, but several drivers of cost in include length of stay, readmissions, and outpatient physical therapy. The goal of this study is to utilize bundled episode-of-care data to more accurately assess the impact of postoperative physical therapy after spine surgery.

Methods: A structured query language (SQL) search was performed to collect patient demographics, surgical characteristics, complications, readmissions, and patient-reported outcomes (PROMs) in our cohort. Claim-level data was searched to identify any claims that were associated with physical therapy. Total cost of physical therapy was calculated by adding the cost of each claim relating to physical therapy within a patient’s episode of care.

Results: 758 patients were identified, with 448 (59.1%) participating in at least one physical therapy session after surgery. Patients in the PT group were older (61.6 vs. 59.4, p=0.024), had a greater body mass index BMI (30.6 vs. 29.6, p=0.029), and had more levels fused (1.54 vs. 1.42, p=0.034) than patients in the no PT group. Patients that did not participate in postoperative PT had significantly better preoperative PCS (33.2 vs. 31.1, p=0.003), six-month postoperative PCS (41.1 vs. 35.7, p=0.001), and six-month delta PCS (9.24 vs. 4.92, p=0.026) compared to patients who participated in postoperative PT. At one-year follow-up, patients who did not participate in PT had less leg pain (VAS Leg 2.89 vs. 3.99, p=0.041) than those who did participate in PT. Correlation analysis of the number of physical therapy sessions attended after surgery and all PROMs at six months and one year showed no relationship. Average cost of physical therapy per patient was $1,521.57.

Conclusion : Our study finds that physical therapy after lumbar fusion is not associated with significant improvement in patient-reported outcomes. Given the significant cost traditional physical therapy contributes to lumbar fusion episodes of care, alternatives such as home-exercise plans and cognitive-behavioral therapy should be considered to provide high quality, cost-effective care.