The association between prehabilitation participation and spine surgery outcomes

Spine surgery prehabilitation programs aim to optimize patients' functional capacity prior to surgery. The impact of a multi-modal prehabilitation program incorporating physical exercises, home modifications, and preoperative education has not been investigated. This study investigates the impact of a multi-dimensional prehabilitation program within a comprehensive Enhanced Recovery After Surgery (ERAS) program on spine surgery outcomes.

A single-center retrospective cross-sectional study was conducted of patients undergoing elective spine surgery from 2021 to 2024. Patients who underwent prehabilitation were matched with patients who did not undergo prehabilitation based on age, sex, body mass index, co-morbid conditions, and surgery type. Outcomes examined included length of stay, discharge disposition, readmission, Emergency Department (ED) visits, and pre-and post-operative Patient-Reported Outcomes Measurement Information System-Depression (PROMIS-D), Pain Interference (PROMIS-PI) and PROMIS-Physical Function (PROMIS-PF) T-scores. Prehabilitation patients were surveyed on satisfaction and pain levels before and after surgery.

The total sample included 105 prehabilitation and 105 standard-of-care patients. No significant differences were found regarding length of stay, discharge disposition, readmission rates, ED visit rates, PROMIS-D, PROMIS-PI, and PROMIS-PF T-scores. Compared to their baseline scores, prehabilitation patients reported greater preparedness after their procedure and reduced pain (p-value < 0.001); between-group comparisons were not possible due to lack of data available from the standard-of-care group CONCLUSION: While prehabilitation did not significantly impact postoperative outcomes compared to standard of care, prehabilitation did improve patients' feelings of preparedness and comfort for discharge within the prehabilitation group.