Does physical therapy impact clinical outcomes after lumbar decompression surgery?

Area of Science:

• Neurosurgery
• Orthopedics
• Physical Therapy

Background:

• Lumbar decompression surgery is a common procedure for spinal stenosis.
• Patient-reported outcomes (PROMs) and postsurgical readmissions are key metrics for surgical success.
• The role of postoperative physical therapy (PT) in optimizing outcomes after lumbar decompression remains unclear.

Purpose of the Study:

• To evaluate the impact of postoperative physical therapy (PT) on patient-reported outcomes (PROMs) after lumbar decompression surgery.
• To determine if PT influences postsurgical readmissions or reoperations following lumbar decompression.

Main Methods:

• A retrospective study of 1003 patients undergoing primary one- or two-level lumbar decompression.
• Comparison of demographics, surgical characteristics, PROMs, and 90-day readmissions between patients who did and did not attend PT.
• Multivariate linear regression analysis to identify predictors of 90-day readmissions and PROMs at 1-year postoperative.

Main Results:

• Of 1003 patients, 421 attended postoperative PT.
• PT attendance did not significantly impact 90-day surgical reoperations (P=0.225).
• Multivariate analysis revealed no significant difference in PROM improvement; PT was not an independent predictor of 90-day readmissions (P=0.06). Charlson Comorbidity Index and skilled nursing facility discharge independently predicted readmissions.

Conclusions:

• Postoperative physical therapy attendance does not significantly affect clinical improvement as measured by PROMs after lumbar decompression.
• PT does not significantly impact surgical outcomes, including 90-day all-cause or surgical readmissions.
• Comorbidities and discharge disposition are significant predictors of 90-day readmissions post-lumbar decompression.