Driving abstinence is necessary after lumbar spinal fusion: a prospective cohort study.
Studies on driving safety after lumbar spinal procedures are rare. Previous studies solely reported on a) driving reaction time (DRT) after lumbar nerve root blocks, b) DRT after discectomy and c) preliminary DRT findings after lumbar fusion.



DRT was assessed with a driving simulator as described before. Measurements were done one day before surgery (preop DRT), one week after surgery (postop1 DRT), three months (postop2 DRT) and one year postoperatively (postop3 DRT). Back pain was determined with visual analogue scales (VAS) on all four occasions. Additionally, we monitored each patient's pre-operative driving frequency and intake of analgesics. For statistical analysis we used an ANOVA for repeated measurements.



Thirt eight of 51 patients completed all measurements (17 monosegmental fusion, 14 polysegmental fusion, seven other lumbar fusion procedures). The longitudinal changes in DRT showed overall significance (p = 0.013). Post-hoc tests determined p = 0.035 for the DRT-increase from pre- to postoperative. We did not determine a significant statistical effect for the type of surgery (p = 0.581) or patient age (p = 0.134). A tendency towards statistical significance was ascertained for the influence of patients' driving frequency on DRT (p = 0.051).



We found increased DRT at the time of discharge after lumbar spinal fusion and therefore recommend driving abstinence for the time thereafter. Based on our findings it appears safe to return to driving at 3 months postoperative.
Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.
Michael C
MC
Liebensteiner
Department of Surgery, Regional Hospital St. Johann, Bahnhofstraße 14, 6380, St. Johann in Tirol, Austria.
Franz
F
Birkfellner
Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.
Martina
M
Deibl
Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.
Christian
C
Haid
Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria.
Martin
M
Krismer
Department of Orthopaedics, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria. dietmar.dammerer@tirol-kliniken.at.
Dietmar
D
Dammerer
D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000706:statistics & numerical data*; D001416:Back Pain / Q000601:surgery; D015331:Cohort Studies; D017586:Diskectomy; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D061214:Patient Safety; D011446:Prospective Studies; D011930:Reaction Time; D013123:Spinal Fusion / Q000379:methods*; D055815:Young Adult
Brake response time; Driving ability; Driving reaction; Driving safety; Lower back pain; Lumbar fusion