Prehabilitation Improves Early Outcomes in Lumbar Spinal Stenosis Surgery: A Pilot Randomized Controlled Trial.

IF 1.7 4区医学 Q3 CLINICAL NEUROLOGY Clinical Spine Surgery Pub Date : 2025-12-01 Epub Date: 2025-03-04 DOI:10.1097/BSD.0000000000001779

Hiroto Takenaka, Mitsuhiro Kamiya, Junya Suzuki

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Abstract

Study design: A pilot randomized controlled trial.

Objective: To investigate the effects of a prehabilitation program on early postoperative outcomes in Japanese patients undergoing lumbar spinal stenosis (LSS) surgery.

Summary of background data: Prehabilitation has shown promise for improving postoperative outcomes in various surgical populations. However, its effectiveness in Japanese patients undergoing LSS surgery has not been previously studied.

Methods: Thirty-two of 34 patients scheduled for LSS surgery (mean age: 69.3 y, 17 female) were randomly assigned to the prehabilitation group (15 patients) or control group (17 patients). The primary outcomes were the Oswestry Disability Index (ODI) and 6-minute walk distance (6MWD). The secondary endpoints were the visual analog scale (VAS) scores for back pain, leg pain, and numbness. The intervention group received a 20-30-minute educational session from a physical or occupational therapist using a pamphlet 1 month before surgery, while the control group received a pamphlet handout. Assessments were conducted 1 month before surgery (baseline); 1 day before surgery; and 1, 3, and 6 months postoperatively.

Results: All patients underwent preoperative educational sessions. The prehabilitation group showed significant improvements in 6MWD at 3 months postoperatively compared with the control group (446.8±48.9 m vs. 384.3±58.3 m, P =0.01, Hedges' g=1.11). ODI scores at 1 month postoperatively were lower in the prehabilitation group (10.2±10.9 vs. 19.0±10.7, P =0.04, Hedges' g=-0.77). Low back pain VAS at 3 months postoperatively was also lower in the prehabilitation group (12.5±14.8 vs. 27.5±20.8, P =0.04, Hedges' g=0.75). No adverse events were reported in either of the groups.

Conclusions: Prehabilitation may enhance postoperative recovery and outcomes in patients undergoing surgery for LSS. Further research with a larger sample size is needed to establish the effectiveness of prehabilitation in this population.

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预适应改善腰椎管狭窄手术的早期预后：一项随机对照试验。

研究设计：随机对照试验。目的：探讨康复训练对日本腰椎管狭窄症（LSS）患者术后早期预后的影响。背景资料摘要：在不同的手术人群中，预康复已显示出改善术后预后的希望。然而，其在接受LSS手术的日本患者中的有效性尚未得到研究。方法：将34例拟行LSS手术的患者32例（平均年龄69.3岁，女性17例）随机分为康复组（15例）和对照组（17例）。主要指标为Oswestry残疾指数（ODI）和6分钟步行距离（6MWD）。次要终点是背部疼痛、腿部疼痛和麻木的视觉模拟量表（VAS）评分。干预组在手术前1个月接受物理或职业治疗师使用小册子的20-30分钟教育课程，而对照组则接受小册子讲义。术前1个月进行评估（基线）；术前1天；术后1、3、6个月。结果：所有患者均接受术前教育。预康复组术后3个月6MWD较对照组明显改善（446.8±48.9 m∶384.3±58.3 m， P=0.01, Hedges’g=1.11）。术后1个月ODI评分低于康复组（10.2±10.9比19.0±10.7，P=0.04, Hedges' g=-0.77）。术后3个月，康复组腰痛VAS评分也较低（12.5±14.8比27.5±20.8，P=0.04, Hedges' g=0.75）。两组均未报告不良事件。结论：预适应可以提高LSS手术患者的术后恢复和预后。需要更大样本量的进一步研究来确定在这一人群中康复的有效性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.