Assessing the Utility of Pedometer Data in Predicting Spine Surgery Outcomes: A Scoping Review of Clinical Progress

Pedometer data has been historically used as a metric of early mobilization and functional recovery after spine surgery. Wearable pedometers augment traditional patient-reported outcome measures (PROMs) after spine surgery. We aimed to synthesize current findings of studies that measured changes in step counts before and after spine surgery, to re-examine the utility of pedometer data as a meaningful recovery metric. A scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, Embase, and Scopus were searched from inception to March 2025. Articles were independently screened and extracted for relevant data. Of 378 records, 18 studies (n=677) met the inclusion criteria. Procedures included decompression (n=8), fusion (n=5), adolescent idiopathic scoliosis posterior fusion (n=3), and multi-level deformity surgery (n=2). Devices included Fitbit, ActiGraph, Mi Band, Apple Health, ActivPal3, MetaMotionC, and a miniature inertial measurement unit. Across procedures, step counts fell sharply in the first postoperative weeks (up to -70%) and returned to or exceeded baseline within 6–12 months; adolescent patients recovered fastest (median 4 weeks). Higher preoperative activity and early postoperative gains predicted superior pain and functional scores in several cohorts, whereas correlations between absolute step counts and PROMs were inconsistent. Reported device-related or monitoring-related adverse events were negligible. Step count monitoring reliably captures recovery trajectory after spine operations and shows preliminary promise as a prognostic marker. Moderate correlations were found between step count data and operation efficacy. Standardizing sensor choice, sampling windows, and analytic endpoints are essential for integrating pedometer data into perioperative care and rehabilitation.