Prehabilitation for spine surgery: A scoping review

Area of Science:

• Spine Surgery
• Prehabilitation
• Systematic Review

Background:

• Prehabilitation programs are increasingly recognized for their potential to enhance patient outcomes.
• However, current interventions for spine surgery prehabilitation are not well-defined, necessitating a comprehensive review.

Purpose of the Study:

• To identify and describe current prehabilitation interventions for spine surgery.
• To explore knowledge gaps in approaches, feasibility, timing, patient experience, clinical outcomes, and costs.
• To describe potential benefits on physical and psychological outcomes.

Main Methods:

• A systematic electronic search was conducted from January 2004 to February 2022 across multiple databases.
• Studies evaluating adults in prehabilitation before elective spine surgery were included.
• Data extraction and synthesis followed Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.

Main Results:

• Twenty-three studies met eligibility criteria from 18,879 potential studies.
• Prehabilitation programs included general education, exercise, cognitive behavioral therapy, pain neuroscience education, health behavior counseling, and mindfulness.
• Programs appear feasible, reduce costs, and improve postoperative pain, disability, self-efficacy, psychological behaviors, and satisfaction.

Conclusions:

• Limited but promising evidence suggests prehabilitation is feasible and beneficial for spine surgery patients.
• Further research is required to determine optimal patient characteristics and intervention strategies.
• Prehabilitation offers an opportunity to enhance patient experience, clinical outcomes, and reduce healthcare costs in spine surgery.