The impact of prehabilitation on postoperative outcomes in spine surgery: A systematic review and meta-analysis.

IF 1.4 4区 医学 Q3 ORTHOPEDICS
Zuyao Liu, Deng Yang
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引用次数: 0

Abstract

BackgroundPrehabilitation aims to optimize patients' physical and psychological status before spine surgery to enhance recovery. However, its effectiveness on postoperative outcomes remains remains to be controversial. This meta-analysis aims to evaluate Prehabilitation impact on pain, functional recovery, psychological status, and perioperative outcomes.MethodsA systematic search of MEDLINE/PubMed, Web of Science, Scopus, and Embase was conducted through January 2025 using PRISMA guidelines. A total of 5738 records were initially identified through database searches, of which 3765 remained after duplicate removal. Studies comparing postoperative outcomes in patients undergoing spine surgery with and without prehabilitation were included. Meta-analysis was performed using a random-effects model, with subgroup analyses based on exercise inclusion.ResultsAccording to our inclusion criteria, twenty-seven studies (2449 participants) were deemed appropriate to be included in our study. Our meta-analysis showed prehabilitation significantly reduced postoperative back pain (SMD = -0.4028, p = 0.0269) and improved trunk muscle strength (SMD = 0.1472, p = 0.0142). However, no significant differences were observed for disability (SMD = -0.3772, p-value = 0.5705), quality of life (SMD = 0.0657, p-value = 0.5372), and leg pain (SMD = -0.1921, p-value = 0.3920). In addition, depression, operation time, blood loss, or length of stay were shown to be comparable between the two groups of patients.ConclusionsPrehabilitation may reduce postoperative back pain and improve muscle function, but does not significantly impact disability, quality of life, or perioperative outcomes. Future research should refine protocols and identify patient subgroups that benefit most from prehabilitation.

脊柱外科术后康复对预后的影响:系统回顾和荟萃分析。
背景预康复旨在优化脊柱手术前患者的生理和心理状态,以促进康复。然而,其对术后预后的有效性仍然存在争议。本荟萃分析旨在评估预康复对疼痛、功能恢复、心理状态和围手术期结局的影响。方法采用PRISMA指南系统检索MEDLINE/PubMed、Web of Science、Scopus和Embase数据库,检索时间截止到2025年1月。最初通过数据库搜索确定了5738条记录,其中3765条在删除重复后仍然存在。比较脊柱手术患者有和没有预适应的术后结果的研究被纳入。采用随机效应模型进行meta分析,并基于运动纳入进行亚组分析。结果根据我们的纳入标准,27项研究(2449名受试者)被认为适合纳入我们的研究。我们的荟萃分析显示,预适应可显著减轻术后背部疼痛(SMD = -0.4028, p = 0.0269),改善躯干肌肉力量(SMD = 0.1472, p = 0.0142)。然而,在残疾(SMD = -0.3772, p值= 0.5705)、生活质量(SMD = 0.0657, p值= 0.5372)和腿痛(SMD = -0.1921, p值= 0.3920)方面没有观察到显著差异。此外,两组患者的抑郁、手术时间、出血量或住院时间均具有可比性。结论康复治疗可减轻术后背部疼痛,改善肌肉功能,但对残疾、生活质量和围手术期预后无明显影响。未来的研究应该完善方案,并确定从康复中获益最多的患者亚组。
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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
194
审稿时长
6 months
期刊介绍: The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty. In each issue clinicians can find information which they can use in their patient setting the very next day.
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