Assessing the outcomes of spine surgery using global positioning systems.
METHODS
Pilot study.


OBJECTIVE
To examine whether surgical outcomes can be assessed objectively by advanced tracking technology, based on Global Positioning Systems (GPS).


BACKGROUND
Outcome studies are the commonest way to assess the results of surgical procedures. The success of these efforts is impeded by a number of factors, including the lack of valid outcome measures, difficulty in assessing changes in patients' expectations (response shift) and confounding effects of secondary gains.


METHODS
The measurement of walking speed, distances, and number of walking events per day, claudication index (maximal walking distance), characteristics during motorized trips, and the amount of time spent outdoors were monitored in 2 patients undergoing spine surgery for several weeks using advanced tracking technologies.


RESULTS
In 1 patient, all parameters increased progressively from the time of surgery to the end of the recording period. These findings were consistent with her recovery from surgery. In a second patient, tracking showed the patient's difficulty in mobilizing, leading to the diagnosis of another orthopedic problem, and to total hip replacement surgery.


CONCLUSIONS
The technology presented in this pilot appears to be useful in understanding a patient's level and breathe of activity. These data will assist in better understanding the limitations imposed by specific musculoskeletal pathology and in monitoring perioperative function and complications and their related causes. Spatial data may indirectly reflect a patient's social and mental conditions. This interdisciplinary pilot may lead to the development of valid outcome measures for a range of medical conditions. Studies comparing questionnaires to this new outcome measure may shed light on issues like response shifts and secondary gain. Norms and clusters of spatial behaviors in different pathologies may enable better patient selection for medical, mental, and surgical interventions.
Barzilay
Yair
Y
Department of Orthopedic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel. dbar@hadassah.org.il
Yair
Barzilay
B
Noam
Shoval
S
Meir
Liebergall
L
Gail
Auslander
A
Amit
Birenboim
B
Michal
Isaacson
I
Vaccaro
Alexander R
AR
Leon
Kaplan
K
D000368:Aged; D017586:Diskectomy; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010865:Pilot Projects; D020127:Recovery of Function; D015203:Reproducibility of Results; D013122:Spinal Diseases / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion; D013997:Time Factors; D016138:Walking