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Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis
Published on: March 23, 2019
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Physical Therapy Utilization After Single-level Posterior Lumbar Fusion.
Michael J Gouzoulis1, Jay Moran1, Seongho Jeong1
1Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT.
Spine
|February 13, 2024
Summary
A minority of patients receive physical therapy after posterior lumbar fusion (PLF). Insurance and location significantly influence PT access, indicating a need for standardized care following this common spinal surgery.
Area of Science:
- Spine surgery outcomes
- Rehabilitation medicine
- Health services research
Background:
- Posterior lumbar fusion (PLF) is a prevalent and increasing spinal surgical procedure.
- Physical therapy (PT) is often recommended post-PLF to aid recovery and return to activities.
- Current literature lacks comprehensive characterization of PT utilization patterns after PLF.
Purpose of the Study:
- To analyze the utilization rates of physical therapy (PT) following single-level posterior lumbar fusion (PLF).
- To identify patient-specific and demographic factors associated with PT utilization after PLF.
- To examine the timing and type (home vs. outpatient) of PT received post-surgery.
Main Methods:
- Retrospective cohort study utilizing the PearlDiver administrative database (2010-2021).
- Inclusion of patients who underwent single-level PLF.
- Stratification by PT usage, therapy type, and timing; multivariable regression analysis to identify predictors.
Main Results:
- Over 213,000 patients were analyzed; 29% received PT within a year post-PLF.
- Average PT visits were 10.6, with home therapy peaking in month 1 and outpatient in month 2.
- Commercial insurance, Northeast region, older age, female sex, and ECI predicted any PT; Northeast, older age, Medicaid, female sex, and interbody fusion predicted home PT.
Conclusions:
- The majority of patients do not receive formal physical therapy after single-level PLF.
- Significant variations in PT utilization exist, influenced by non-clinical factors like insurance and geography.
- Opportunities exist to develop more consistent and equitable PT practice patterns post-PLF.
