• Neurosurgery · Sep 2022

    Validation of the Benefits of Ambulation Within 8 Hours of Elective Cervical and Lumbar Surgery: A Michigan Spine Surgery Improvement Collaborative Study.

    • Seokchun Lim, Michael Bazydlo, Mohamed Macki, Sameah Haider, Travis Hamilton, Rachel Hunt, Anisse Chaker, Pranish Kantak, Lonni Schultz, David Nerenz, Jason M Schwalb, Muwaffak Abdulhak, Paul Park, Ilyas Aleem, Richard Easton, Jad G Khalil, Miguelangelo J Perez-Cruet, and Victor Chang.
    • Department of Neurosurgery, Henry Ford Hospital, Detroit, Michigan, USA.
    • Neurosurgery. 2022 Sep 1; 91 (3): 505-512.

    BackgroundEarly ambulation is considered a key element to Enhanced Recovery After Surgery protocol after spine surgery.ObjectiveTo investigate whether ambulation less than 8 hours after elective spine surgery is associated with improved outcome.MethodsThe Michigan Spine Surgery Improvement Collaborative database was queried to track all elective cervical and lumbar spine surgery between July 2018 and April 2021. In total, 7647 cervical and 17 616 lumbar cases were divided into 3 cohorts based on time to ambulate after surgery: (1) <8 hours, (2) 8 to 24 hours, and (3) >24 hours.ResultsFor cervical cases, patients who ambulated 8 to 24 hours (adjusted odds ratio [aOR] 1.38; 95% CI 1.11-1.70; P = .003) and >24 hours (aOR 2.20; 95% CI 1.20-4.03; P = .011) after surgery had higher complication rate than those who ambulated within 8 hours of surgery. Similar findings were noted for lumbar cases with patients who ambulated 8 to 24 hours (aOR 1.31; 95% CI 1.12-1.54; P < .001) and >24 hours (aOR 1.96; 95% CI 1.50-2.56; P < .001) after surgery having significantly higher complication rate than those ambulated <8 hours after surgery. Analysis of secondary outcomes for cervical cases demonstrated that <8-hour ambulation was associated with home discharge, shorter hospital stay, lower 90-day readmission, and lower urinary retention rate. For lumbar cases, <8-hour ambulation was associated with shorter hospital stay, satisfaction with surgery, lower 30-day readmission, home discharge, and lower urinary retention rate.ConclusionAmbulation within 8 hours after surgery is associated with significant improved outcome after elective cervical and lumbar spine surgery.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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