What are the prognostic factors of early ambulation after spinal arthrodesis surgery? A retrospective study

Background

After spinal surgery, early mobilisation programmes are playing an increasing role in managing pain symptoms, reducing length of hospital stay and preventing complications. The aim of the study is to investigate what are the prognostic factors of early ambulation after spinal arthrodesis surgery.

Methods

A retrospective cohort study was carried. Patients who underwent vertebral arthrodesis surgery with at least one fixed level of instrumental fixation were included consecutively. The primary outcome was represented by the precocity of ambulation. The variables collected were divided in anamnestic data and surgical/post-surgical variables. Data were collected by consulting the computerised medical records.

Results

A total of 376 patients were evaluated. Mean mobilisation recovery time was 3 days after surgery. The mean age of the patients was 53 years and 60.9% was female. The association between the primary outcome, time to onset of ambulation, and the other variables was investigated using univariate analysis. Multiple linear regression used, shows that age (B = 0.016; p = 0.029), duration of surgery (B = 0.636; p < 0.001), degree of anaesthesia risk (B = 0.629; p = 0.031) and number of stabilised levels (from 5 to 9 levels: B = 0.840; p < 0.043; more than 10 levels: B = 0.629; p = 0.057) were independent predictors of early recovery of ambulation.

Conclusion

Increasing age, a more compromised preoperative clinical picture, a longer duration of surgery and number of stabilisation levels are factors associated with increased walking recovery time after spinal arthrodesis surgery. These factors may make it possible to identify patients at increased risk of delayed ambulation recovery and tailor the rehabilitation intervention.