Objective:

Given the paucity of relevant data, the Council of State Neurosurgical Societies (CSNS) Workforce Committee launched a survey of neurosurgeons to assess patterns in activity restriction recommendations following spine surgery; the ultimate goal was to optimize and potentially standardize these recommendations. The aim of this initial study was to determine current practices in f activity restrictions and return to work guidelines following common spinal procedures.

Methods:

The survey included questions regarding general demographics and practice data, postoperative bracing/orthoses utilization, and guidelines for postoperative return to different levels of activity/types of work following specific spine surgery interventions. A spectrum of typical spine surgeries was assessed, including microdiscectomy, anterior cervical discectomy and fusion (ACDF), and lumbar fusion (open and minimal invasive surgery (MIS) approaches).

Results:

There was significant inter- and intra-procedure variation in neurosurgeon recommendations for postoperative activity and return to work recommendations after various spinal surgery procedures. Comparison between the different surgical procedures evaluated revealed significant differences in cervical collar usage (more often used following two level or greater ACDF than single level ACDF, p<0.001), return to both sedentary and light physical work (greater restriction with a two level or greater ACDF than single level ACDF, p<0.001), and return to a light exercise regimen (sooner following MIS vs. open lumbar fusion, p<0.001).

Conclusions:

This survey demonstrated little consistency regarding return to work recommendations, general activity restrictions and orthosis utilization following common spinal surgical procedures. Addressing this issue also has significant implication for the societal and personal costs of spine surgery.