Return to Work Guidelines Following Neurosurgical Procedures

Guglielmi, Gina; Seibly, Jason

doi:10.7759/cureus.11982

Cited by 5 publications

(3 citation statements)

References 8 publications

(11 reference statements)

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“…And while the literature on athletes’ return to sport is rather thin, guidelines on return to common activities remains even more sparse. Guglielmi et al [15] surveyed 56 spine surgeons regarding the optimal timing to return to activities of daily living (driving, biking, heavy labor) after ACDF and posterior cervical foraminotomy procedures. In their study, the average recommended time to return to driving was 4 to 6 weeks after a one-level ACDF, and 6 weeks after a multilevel ACDF or posterior cervical foraminotomy.…”

Section: Discussionmentioning

confidence: 99%

Discrepancies in recommendations for return to regular activities after cervical spine surgery: A survey study

Camino-Willhuber,

Tani,

Kelly

et al. 2024

North American Spine Society Journal (NASSJ)

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Section: Discussionmentioning

confidence: 99%

Discrepancies in recommendations for return to regular activities after cervical spine surgery: A survey study

Camino-Willhuber,

Tani,

Kelly

et al. 2024

North American Spine Society Journal (NASSJ)

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“…Over 500,000 spinal fusions are performed annually in the United States at an average cost of ~USD 120,000/per procedure [ 1 ]. With recovery times for full activity ranging from 3 to 12 months [ 2 ] and failure rates varying from 10 to 36% [ 3 , 4 ], there is clearly a need to explore alternative strategies for improving the procedure [ 1 ]. Thus, prolonged postoperative immobilization increases the risk for comorbidities and reduces quality of life, while fusion failure imposes a need for additional surgical interventions and/or prolonged restriction of mobility [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Targeted Delivery of Abaloparatide to Spinal Fusion Site Accelerates Fusion Process in Rats

Nielsen,

Low,

Chen

et al. 2024

Biomedicines

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Spinal fusions are performed to treat congenital skeletal malformations, spondylosis, degenerative disk diseases, and other pathologies of the vertebrae that can be resolved by reducing motion between neighboring vertebrae. Unfortunately, up to 100,000 fusion procedures fail per year in the United States, suggesting that efforts to develop new approaches to improve spinal fusions are justified. We have explored whether the use of an osteotropic oligopeptide to target an attached bone anabolic agent to the fusion site might be exploited to both accelerate the mineralization process and improve the overall success rate of spinal fusions. The data presented below demonstrate that subcutaneous administration of a modified abaloparatide conjugated to 20 mer of D-glutamic acid not only localizes at the spinal fusion site but also outperforms the standard of care (topically applied BMP2) in both speed of mineralization (p < 0.05) and overall fusion success rate (p < 0.05) in a posterior lateral spinal fusion model in male and female rats, with no accompanying ectopic mineralization. Because the bone-localizing conjugate can be administered ad libitum post-surgery, and since the procedure appears to improve on standard of care, we conclude that administration of a bone-homing anabolic agent for improvement of spinal fusion surgeries warrants further exploration.

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“…By 3 months, most patients have successfully navigated their PO restrictions and recovery and have returned to full activities without restrictions. Guglielmi and Seibly 6 aimed to provide a framework for a return to work and activity. The authors determined driving and light duty can be safely recommended in the first 1-2 weeks and full activity without restrictions by 3 months.…”

mentioning

confidence: 99%

Is Long-term Follow-up for Asymptomatic Patients After Lumbar Fusion Necessary?

Petrone

Caballero

et al. 2023

Clinical Spine Surgery: A Spine Publication

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For purposes of this discussion, we define "longterm" outpatient follow-up as scheduled office visits after 3 months or more postoperatively. "Asymptomatic/minimally symptomatic" is defined as having mild to no symptoms and being able to return to all desired activities. The rate of complex lumbar fusion procedures increased by 32% from 2004 to 2015. 1 As such, there has been a proportionate increase in postoperative (PO) follow-up visits. Currently, there is a dearth of evidence regarding the optimum timeline for how long a patient should be followed postoperatively from a lumbar spinal fusion. The addition of continued outpatient clinic appointments for up to 1-2 years is likely a result of spine surgeons adopting similar workflows derived from their training. We suggest ~3 months time after lumbar spinal fusion is sufficient follow-up for asymptomatic patients. This time point is suggested because this is when most restrictions have been lifted for minimally symptomatic patients, and they have returned to all activities and work if applicable. To avoid unnecessary utilization of time and resources, an endpoint should be identified wherein the maximum benefit is achieved including the identification of complications, and outcomes are not adversely affected.The majority of PO complications occur within 3 months of surgery. In a meta-analysis by Veeravagu et al, 2 the authors found the majority of infections, wound dehiscence, and other wound complications had the highest occurrence rate 10-20 days postoperatively. Mehrotra et al 3 concluded that lumbar fusions have a 1.54% rate of wound complications within the first 30 days and a 1.17% rate of reoperation within 90 days. Eliasberg et al 4 retrospectively reviewed over 50,000 lumbar fusions and found a 90-day reoperation rate of only 4%. Martin et al 5 analyzed 2345 lumbar fusion procedures to determine their reoperation rates and causes. They found an

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Return to Work Guidelines Following Neurosurgical Procedures

Cited by 5 publications

References 8 publications

Discrepancies in recommendations for return to regular activities after cervical spine surgery: A survey study

Discrepancies in recommendations for return to regular activities after cervical spine surgery: A survey study

Targeted Delivery of Abaloparatide to Spinal Fusion Site Accelerates Fusion Process in Rats

Is Long-term Follow-up for Asymptomatic Patients After Lumbar Fusion Necessary?

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