Oral Presentation 51st International Society for the Study of the Lumbar Spine Annual Meeting 2025

The Effect of Lumbar Decompression on Patients’ Disability Measured by Spine Specific Wearables (115743)

Ram Haddas 1 , Ashley Lynn Rogerson 1 , Yair Barzilay 2 , Kade Kaufmann 1 , Addisu Mesfin 3 , Varun Puvanesarajah 1 , Paul Rubery 1
  1. University of Rochester Medical Center, Rochester, NY, United States
  2. Spine, Shaare Zedek Medical Center, Jerusalem, Iarael
  3. MedStar Health, Washington, DC

Introduction: Lumbar decompression for radiculopathy secondary to nerve root compression is a common procedure, leading to improvement in function in the appropriately selected patient.1 Continuous, remote objective measurement of patients’ function offers a novel approach for characterizing disability and surgical outcomes.2-5 We describe and validate a spine-specific wearable system to capture trunk kinematics, spatiotemporal parameters, and type of activity in the post-operative patient.2 Therefore, the purpose of this study was to assess the effect of lumbar decompression and fusion on patient’s disability utilizing spine specific wearables.

Methods: Patients underwent lumbar spine decompression with fusion. A week before (Pre) and 3 month following surgery (Post3), spine specific wearables were attached to patient’s base of neck and passively recorded disability and functional outcomes for 3 days. At the end of each day, ODI and PROMIS were answered by patients. Repeated-measurements ANOVA was used to compare outcomes before and after surgery using SPSS (IBM 2023). 

Results: Disability and function were improved following lumbar decompression and fusion as cited by spine-specific wearables and PROMIS. The volume of activities was significantly increased following surgery (% of the day; walking Pre: 16.0±9.1 vs Post3: 24±8.7, p<0.05;). Moreover, trunk RoM was increased (Sagittal: Pre: 30.4±11.3 vs Post3: 45.2±15.6⸰, p<0.05, Coronal: Pre: 30.0±12.9 vs Post3: 45.4±12.9⸰, p<0.05). Furthermore, PROMIS and ODI scores were significantly improved (PROMIS Physical Function: Pre: 71.1±9.7 vs Post3: 58.5±12.4, p<0.05; PROMIS Pain Interference: Pre: 69.4±11.4 vs Post3: 56.7±10.1, p<0.05; PROMIS Mood: Pre: 65.9±4.0 vs Post3: 60.1±7.7, p<0.05; ODI: Pre: 45.9±12.7 vs Post3: 32.3±11.7, p<0.05;).  Although, DFOMs were improved in LD patients, they were still significantly different from an age and gender matched controls (p>0.05). LD patients presented with lower free-living physical function along with reduced trunk kinematics (walking: 4.7±2.1%, standing: 11.6±3.6%, sitting: 25.3±12.8%, and laying down: 41.7±12.2% of the day, trunk flexion: 15.8±6.7°) at their home-based environment in comparison to controls (walking: 8.9±2.1%, standing: 19.1±4.9%, sitting: 17.1±9.7%, and laying down: 36.2±11.0% of the day, trunk flexion: 10.3±4.7°; p<0.05). Moreover, LD patients demonstrated reduced balance and gait with increased sway (balance effort: 25.6±11.7°, walking: 0.8±0.3 m/s, sway: sagittal: 7.9±2.8°, coronal: 7.2±3.0°) compared to controls (balance effort: 14.6±5.7°, walking: 1.0±4.4 m/s, sway: sagittal: 5.8±2.5°, coronal: 3.2±1.3°; Figure 2). Strong correlations were found between wearable DFOMs to the PROMIS scores (r2 >0.55, p<0.05).

Discussion: Lumbar decompression and fusion have been demonstrated to decrease disability and improve function in patients with radicular pain caused by nerve root compression. A novel spine-specific wearable system was able to quantify the patient’s disability and functional level, with a good correlation to improvements reported in PROMs. A combination of disability and function outcome measurements (DFOMs) to supplement PROMs and radiographic measurements provides a more comprehensive evaluation of a spine patient’s health and assists physician planning treatment. It may also be possible for healthcare providers to view their patients' DFOMs in real-time, allowing them to monitor their progress and refine their patient care accordingly.

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