Key result
Regular preoperative exercise was associated with fewer postoperative adverse events (OR 0.72; 95% CI 0.57-0.91; p=0.006) and shorter hospital stays compared to infrequent or no exercise.
Why the study?
To determine whether self-reported preoperative exercise is associated with postoperative outcomes after lumbar fusion spinal surgery.
Does regular preoperative exercise reduce adverse events and hospital length of stay in patients undergoing elective single-level lumbar fusion spinal surgery?
Cohort (n=2,203)
Yes
Does regular preoperative exercise reduce adverse events and hospital length of stay in patients undergoing elective single-level lumbar fusion spinal surgery?
Odds Ratio: 0.72 (95% CI 0.57–0.91)
p-value: p=0.006
Regular preoperative exercise (twice or more per week) is associated with fewer postoperative adverse events and shorter hospital stays in patients undergoing elective single-level lumbar fusion spinal surgery.
Supports preoperative exercise counseling before lumbar fusion; leaves open confirmation of causality in RCTs.
Purpose: To determine whether there was an association between self-reported preoperative exercise and postoperative outcomes after lumbar fusion spinal surgery. Method: We performed a retrospective multivariable analysis of the prospective Canadian Spine Outcomes and Research Network (CSORN) database of 2,203 patients who had elective single-level lumbar fusion spinal surgeries. We compared adverse events and hospital length of stay between patients who reported regular exercise (twice or more per week) prior to surgery (“Regular Exercise”) to those exercising infrequently (once or less per week) (“Infrequent Exercise”) or those who did no exercise (“No Exercise”). For all final analyses, we compared the Regular Exercise group to the combined Infrequent Exercise or No Exercise group. Results: After making adjustments for known confounding factors, we demonstrated that patients in the Regular Exercise group had fewer adverse events (adjusted odds ratio 0.72; 95% CI: 0.57, 0.91; p = 0.006) and significantly shorter lengths of stay (adjusted mean 2.2 vs. 2.5 d, p = 0.029) than the combined Infrequent Exercise or No Exercise group. Conclusions: Patients who exercised regularly twice or more per week prior to surgery had fewer postoperative adverse events and significantly shorter hospital lengths of stay compared to patients that exercised infrequently or did no exercise. Further study is required to determine effectiveness of a targeted prehabilitation programme.
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Lawrence et al. (2022) conducted a cohort in Elective single-level lumbar fusion spinal surgeries (n=2,203). Regular preoperative exercise (twice or more per week) vs. Infrequent exercise (once or less per week) or no exercise was evaluated on Adverse events (OR 0.72, 95% CI 0.57-0.91, p=0.006). Regular preoperative exercise was associated with fewer postoperative adverse events (OR 0.72; 95% CI 0.57-0.91; p=0.006) and shorter hospital stays compared to infrequent or no exercise.
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