title: Driving reaction time before and after surgery for disc herniation in patients with preoperative paresis.
abstract: BACKGROUND
  The effect of many types of surgeries on driving reaction time (DRT) has been reported. Although lumbar disc herniation is one of the most common spinal diseases, the effect on DRT has not been investigated.
  
  
  OBJECTIVE
  To assess the effect of left- and right-sided pareses caused by lumbar disc herniation on DRT before and after surgery.
  
  
  METHODS
  Controlled prospective clinical trial.
  
  
  METHODS
  Patients undergoing disc surgery.
  
  
  METHODS
  Impact of paresis caused by lumbar disc herniation and disc surgery on DRT.
  
  
  METHODS
  Forty-two consecutive patients (mean age, 50.3 years) were tested for DRT 1 day before surgery, postoperatively before hospital discharge, and 5 weeks after surgery. Visual analogue scale (VAS) for back and leg pain as well as pain medication and patients' driving frequency were recorded.
  
  
  RESULTS
  Significant improvement of DRT after surgery was seen in patients with left- and right-sided pareses (p<.005). For the right-sided paresis group, the preoperative DRT was 761 ms (median, interquartile range [IQR]: 490), 711 ms (median, IQR: 210) immediately postoperatively, and 645 ms (median, IQR: 150) at follow-up (FU). For the left-sided paresis group, DRT was 651 ms (median, IQR: 270) preoperatively, 592 ms (median, IQR: 260) postoperatively, and 569 ms (median, IQR: 140) at FU. Significant differences between right- and left-sided pareses were identified preoperatively and at FU testing (p<.005). No correlation was found between VAS for leg or back pain and DRT. Historical control subjects had a DRT of 487 (median, IQR: 116), which differed significantly at all three test times (p<.001).
  
  
  CONCLUSIONS
  A significant reduction in DRT in patients with right- and left-sided pareses was found after surgery, indicating a positive effect of surgery. The improvement in DRT seen immediately postoperatively and the lack of a generally accepted threshold for DRT would suggest that for both patient samples, it is safe to continue driving after hospital discharge. However, patients should be informed accordingly.
authors.affiliation: Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. Electronic address: martin.thaler@uki.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Thaler
authors.affiliation: Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Ricarda
authors.initials: R
authors.lastname: Lechner
authors.affiliation: Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Foedinger
authors.affiliation: Department of Orthopaedic Surgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Haid
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Pujan
authors.initials: P
authors.lastname: Kavakebi
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Galiano
authors.affiliation: Department of Neurosurgery, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
authors.forename: Alois
authors.initials: A
authors.lastname: Obwegeser
mesh_terms: D000328:Adult; D000368:Aged; D001334:Automobile Driving; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D010291:Paresis / Q000601:surgery*; D011446:Prospective Studies; D011930:Reaction Time
keywords: Driving reaction time; Driving safety; Lumbar disc herniation; Lumbar disc surgery; Paresis