• Takashi Hirase, Francis Lovecchio, Myles Allen, Chukwuebuka C Achebe, Michael Mazzucco, Robert N Uzzo, Gregory S Kazarian, Tomoyuki Asada, Hiroyuki Nakarai, Tejas Subramanian, Chad Simon, Atahan Durbas, Austin Kaidi, Kasra Araghi, Justin Samuel, Cole Kwas, Todd J Albert, and Han Jo Kim.
• Hospital for Special Surgery, Department of Spine Surgery, 535 E. 71st St, New York, New York, 10021, USA.
• Spine. 2024 May 29.

Study DesignRetrospective cohort study.ObjectiveTo determine the relationship between preoperative physical therapy (PT) and postoperative mobility, adverse events (AEs), and length of stay (LOS) among patients with low normalized total psoas area (NTPA) undergoing ASD surgery.Summary Of Background DataSarcopenia as defined by low NTPA has been shown to predict poor perioperative outcomes following adult spinal deformity (ASD) surgery. However, there is limited evidence correlating the benefits of PT within the sarcopenic patient population.MethodsNTPA was analyzed at the L3 and L4 mid-vertebral body on preoperative magnetic resonance imaging (MRI). Receiver operating characteristic (ROC) curve analysis was used to determine gender-specific NTPA cut-off values for predicting perioperative AEs. Patients were categorized as having low NTPA if both L3 and L4 NTPA were below these cut-off values. Perioperative outcomes were compared between patients with low NTPA that underwent documented formal PT within 6 months prior to ASD surgery with those that did not.Results103 patients (42 males, 61 females) met criteria for low NTPA for inclusion in the study, of which 42 underwent preoperative PT and 61 did not. The preoperative PT group had a shorter LOS (111.2±37.5 vs. 162.1±97.0 h, P<0.001), higher ambulation distances (feet) on postoperative day (POD) 1 (61.7±50.3 vs. 26.1±69.0, P<0.001), POD 2 (113.2±81.8 vs. 62.1±73.1, P=0.003), and POD 3 (126.0±61.2 vs. 91.2±72.6, P=0.029), and lower rates of total AEs (31.0% vs. 54.1%, P=0.003) when excluding anemia requiring transfusion. Multivariable analysis found preoperative PT to be the most significant predictor of decreased LOS (OR 0.32, P=0.013).ConclusionSarcopenic patients may benefit from formal preoperative PT prior to undergoing ASD surgery to improve early postoperative mobility, decrease AEs, and decrease LOS.Level Of Evidence3.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

8 keywords...

hide…