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When Is It Safe to Return to Driving After Spinal Surgery?

Scott TP, Pannel W, Savin D, Ngo SS, Ellerman J, Toy K, Daubs MD, Lu D, Wang JC - Global Spine J (2015)

Bottom Line: There are limited data about the effect of cervical and lumbar surgery on DRT.Patients were compared with 14 healthy male controls (mean 32 ± 5.19 years).Results Overall, the patients having cervical and lumbar surgery showed no significant differences between pre- and postoperative DRT (cervical p = 0.49, lumbar p = 0.196).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States.

ABSTRACT
Study Design Prospective study. Objective Surgeons' recommendations for a safe return to driving following cervical and lumbar surgery vary and are based on empirical data. Driver reaction time (DRT) is an objective measure of the ability to drive safely. There are limited data about the effect of cervical and lumbar surgery on DRT. The purpose of our study was to use the DRT to determine when the patients undergoing a spinal surgery may safely return to driving. Methods We tested 37 patients' DRT using computer software. Twenty-three patients (mean 50.5 ± 17.7 years) received lumbar surgery, and 14 patients had cervical surgery (mean 56.7 ± 10.9 years). Patients were compared with 14 healthy male controls (mean 32 ± 5.19 years). The patients having cervical surgery were subdivided into the anterior versus posterior approach and myelopathic versus nonmyelopathic groups. Patients having lumbar spinal surgery were subdivided by decompression versus fusion with or without decompression and single-level versus multilevel surgery. The patients were tested preoperatively and at 2 to 3, 6, and 12 weeks following the surgery. The use of opioids was noted. Results Overall, the patients having cervical and lumbar surgery showed no significant differences between pre- and postoperative DRT (cervical p = 0.49, lumbar p = 0.196). Only the patients having single-level procedures had a significant improvement from a preoperative DRT of 0.951 seconds (standard deviation 0.255) to 0.794 seconds (standard deviation 0.152) at 2 to 3 weeks (p = 0.012). None of the other subgroups had a difference in the DRT. Conclusions Based on these findings, it may be acceptable to allow patients having a single-level lumbar fusion who are not taking opioids to return to driving as early as 2 weeks following the spinal surgery.

No MeSH data available.


Correlation of visual analog scale (VAS) pain scale and driver reaction time after lumbar spine surgery. We used Spearman correlation to compare reaction times and VAS scores of patients after lumbar spine surgery. There was no statistical relationship either before (p = 0.364) or after surgery (p = 0.964).
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FI1400073-5: Correlation of visual analog scale (VAS) pain scale and driver reaction time after lumbar spine surgery. We used Spearman correlation to compare reaction times and VAS scores of patients after lumbar spine surgery. There was no statistical relationship either before (p = 0.364) or after surgery (p = 0.964).

Mentions: Overall, the 23 patients who received lumbar surgery showed a trend toward decreased DRT. For all the lumbar patients, the mean DRT was 1.012 seconds (SD 0.222) preoperatively and 0.953 seconds (SD 0.222) at the first 2- to 3-week follow-up visit (p = 0.196). At 6 weeks, the mean DRT was 0.842 seconds (SD 0.071) and at 12 weeks it was 0.946 seconds (SD 0.133) The mixed-effects analysis revealed no significant difference in the DRT across all visits (p = 0.110; Table 3, Fig. 4). The Spearman rho analysis of the VAS scores revealed no correlation of pain and DRT. The preoperative Spearman rho was −0.199 (p = 0.364) and the postoperative Spearman rho was 0.011 (p = 0.964; Fig. 5). Likewise, there was no detectable effect of opioid use on the preoperative (p = 0.327) or postoperative (p = 0.353) reaction times (Fig. 6).


When Is It Safe to Return to Driving After Spinal Surgery?

Scott TP, Pannel W, Savin D, Ngo SS, Ellerman J, Toy K, Daubs MD, Lu D, Wang JC - Global Spine J (2015)

Correlation of visual analog scale (VAS) pain scale and driver reaction time after lumbar spine surgery. We used Spearman correlation to compare reaction times and VAS scores of patients after lumbar spine surgery. There was no statistical relationship either before (p = 0.364) or after surgery (p = 0.964).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4516735&req=5

FI1400073-5: Correlation of visual analog scale (VAS) pain scale and driver reaction time after lumbar spine surgery. We used Spearman correlation to compare reaction times and VAS scores of patients after lumbar spine surgery. There was no statistical relationship either before (p = 0.364) or after surgery (p = 0.964).
Mentions: Overall, the 23 patients who received lumbar surgery showed a trend toward decreased DRT. For all the lumbar patients, the mean DRT was 1.012 seconds (SD 0.222) preoperatively and 0.953 seconds (SD 0.222) at the first 2- to 3-week follow-up visit (p = 0.196). At 6 weeks, the mean DRT was 0.842 seconds (SD 0.071) and at 12 weeks it was 0.946 seconds (SD 0.133) The mixed-effects analysis revealed no significant difference in the DRT across all visits (p = 0.110; Table 3, Fig. 4). The Spearman rho analysis of the VAS scores revealed no correlation of pain and DRT. The preoperative Spearman rho was −0.199 (p = 0.364) and the postoperative Spearman rho was 0.011 (p = 0.964; Fig. 5). Likewise, there was no detectable effect of opioid use on the preoperative (p = 0.327) or postoperative (p = 0.353) reaction times (Fig. 6).

Bottom Line: There are limited data about the effect of cervical and lumbar surgery on DRT.Patients were compared with 14 healthy male controls (mean 32 ± 5.19 years).Results Overall, the patients having cervical and lumbar surgery showed no significant differences between pre- and postoperative DRT (cervical p = 0.49, lumbar p = 0.196).

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States.

ABSTRACT
Study Design Prospective study. Objective Surgeons' recommendations for a safe return to driving following cervical and lumbar surgery vary and are based on empirical data. Driver reaction time (DRT) is an objective measure of the ability to drive safely. There are limited data about the effect of cervical and lumbar surgery on DRT. The purpose of our study was to use the DRT to determine when the patients undergoing a spinal surgery may safely return to driving. Methods We tested 37 patients' DRT using computer software. Twenty-three patients (mean 50.5 ± 17.7 years) received lumbar surgery, and 14 patients had cervical surgery (mean 56.7 ± 10.9 years). Patients were compared with 14 healthy male controls (mean 32 ± 5.19 years). The patients having cervical surgery were subdivided into the anterior versus posterior approach and myelopathic versus nonmyelopathic groups. Patients having lumbar spinal surgery were subdivided by decompression versus fusion with or without decompression and single-level versus multilevel surgery. The patients were tested preoperatively and at 2 to 3, 6, and 12 weeks following the surgery. The use of opioids was noted. Results Overall, the patients having cervical and lumbar surgery showed no significant differences between pre- and postoperative DRT (cervical p = 0.49, lumbar p = 0.196). Only the patients having single-level procedures had a significant improvement from a preoperative DRT of 0.951 seconds (standard deviation 0.255) to 0.794 seconds (standard deviation 0.152) at 2 to 3 weeks (p = 0.012). None of the other subgroups had a difference in the DRT. Conclusions Based on these findings, it may be acceptable to allow patients having a single-level lumbar fusion who are not taking opioids to return to driving as early as 2 weeks following the spinal surgery.

No MeSH data available.