Driver Reaction Time Before and After Treatment for Lumbar Radiculopathy

Al-Khayer, Ahmad; Schueler, A.; Kruszewski, G; Armstrong, G.; Grevitt, MP

doi:10.1097/brs.0b013e31817b5bb7

Cited by 36 publications

(39 citation statements)

References 18 publications

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“…One article was excluded because it was published in two different journals [8]. Consequently, six studies met our inclusion criteria and were included in this review (Table 1) [236789]. Among these studies, three studies had reviewed the changes in DRT after lumbar spinal intervention, after cervical spinal surgery in one study, and after cervical or lumbar spinal surgery in one study.…”

Section: Resultsmentioning

confidence: 99%

“…Among these studies, three studies had reviewed the changes in DRT after lumbar spinal intervention, after cervical spinal surgery in one study, and after cervical or lumbar spinal surgery in one study. The range of procedures reviewed included selective nerve root block [2], anterior cervical discectomy and fusion (ACDF) [6], lumbar fusion and/or decompression [379], and posterior sequestrectomy or subtotal discectomy [12]. …”

Section: Resultsmentioning

confidence: 99%

“…Different road authorities have suggested safe DRT, ranging between 700 and 1,500 ms [2]. In an on-road study of normal drivers, the median reaction time in an emergency was found to be 660 ms (range, 300–1,200) [13].…”

Section: Resultsmentioning

confidence: 99%

“…The apparatus used to determine preoperative and postoperative DRT in five of the six reviewed studies was a custom-made in-office driving simulator test that measured drivers' perceptions and reaction times [23678]. The stimulator allowed users to stimulate normal driving habits with an adjustable car seat fixed on a frame with hanging pedals.…”

Section: Methodsmentioning

confidence: 99%

“…Although DRTs can vary depending on variables such as the mental processing time, movement time, and device response time, there are standard or safe ranges reported [23]. Thus, a standardized postoperative DRT might represent an objective indicator of the ability of a patient to safely resume driving after spinal surgery.…”

Section: Introductionmentioning

confidence: 99%

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Driving Safety after Spinal Surgery: A Systematic Review

et al. 2017

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This study aimed to assess driving reaction times (DRTs) after spinal surgery to establish a timeframe for safe resumption of driving by the patient postoperatively. The MEDLINE and Google Scholar databases were analyzed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) Statement for clinical studies that investigated changes in DRTs following cervical and lumbar spinal surgery. Changes in DRTs and patients' clinical presentation, pathology, anatomical level affected, number of spinal levels involved, type of intervention, pain level, and driving skills were assessed. The literature search identified 12 studies that investigated postoperative DRTs. Six studies met the inclusion criteria; five studies assessed changes in DRT after lumbar spine surgery and two studies after cervical spina surgery. The spinal procedures were selective nerve root block, anterior cervical discectomy and fusion, and lumbar fusion and/ordecompression. DRTs exhibited variable responses to spinal surgery and depended on the patients' clinical presentation, spinal level involved, and type of procedure performed. The evidence regarding the patients' ability to resume safe driving after spinal surgery is scarce. Normalization of DRT or a return of DRT to pre-spinal intervention level is a widely accepted indicator for safe driving, with variable levels of statistical significance owing to multiple confounding factors. Considerations of the type of spinal intervention, pain level, opioid consumption, and cognitive function should be factored in the assessment of a patient's ability to safely resume driving.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Driving Safety after Spinal Surgery: A Systematic Review

et al. 2017

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Brake response time returns to the pre-surgical level 6 weeks after unicompartmental knee arthroplasty

Liebensteiner

Rochau

Renz

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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Driving abstinence is necessary after lumbar spinal fusion: a prospective cohort study

Liebensteiner

Birkfellner²,

Deibl

et al. 2016

International Orthopaedics (SICOT)

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Purpose Studies on driving safety after lumbar spinal procedures are rare. Previous studies solely reported on a) driving reaction time (DRT) after lumbar nerve root blocks, b) DRT after discectomy and c) preliminary DRT findings after lumbar fusion. Methods DRT was assessed with a driving simulator as described before. Measurements were done one day before surgery (preop DRT), one week after surgery (postop1 DRT), three months (postop2 DRT) and one year postoperatively (postop3 DRT). Back pain was determined with visual analogue scales (VAS) on all four occasions. Additionally, we monitored each patient's pre-operative driving frequency and intake of analgesics. For statistical analysis we used an ANOVA for repeated measurements. Results Thirt eight of 51 patients completed all measurements (17 monosegmental fusion, 14 polysegmental fusion, seven other lumbar fusion procedures). The longitudinal changes in DRT showed overall significance (p = 0.013). Post-hoc tests determined p = 0.035 for the DRT-increase from pre-to postoperative. We did not determine a significant statistical effect for the type of surgery (p = 0.581) or patient age (p = 0.134). A tendency towards statistical significance was ascertained for the influence of patients' driving frequency on DRT (p = 0.051). Conclusions We found increased DRT at the time of discharge after lumbar spinal fusion and therefore recommend driving abstinence for the time thereafter. Based on our findings it appears safe to return to driving at 3 months postoperative.

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Driver Reaction Time Before and After Treatment for Lumbar Radiculopathy

Cited by 36 publications

References 18 publications

Driving Safety after Spinal Surgery: A Systematic Review

Driving Safety after Spinal Surgery: A Systematic Review

Brake response time returns to the pre-surgical level 6 weeks after unicompartmental knee arthroplasty

Driving abstinence is necessary after lumbar spinal fusion: a prospective cohort study

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