Day one versus day zero postoperative physical therapy among patients with lumbar spinal fusion: a length of stay comparison

BACKGROUND CONTEXT

Postoperative physical therapy (PT) following lumbar spinal fusion is an effective form of postoperative rehabilitation. However, it is unknown when a postoperative PT protocol should be optimally initiated.

PURPOSE

This study sought to compare lengths of stay between patients on a day zero PT protocol and those on a day one PT protocol.

STUDY DESIGN/SETTING

Retrospective chart review.

PATIENT SAMPLE

Patients who underwent lumbar spinal surgery at a large midwestern tertiary medical care center from January 1, 2018 through April 30, 2019 were eligible for their medical record's inclusion.

PRIMARY OUTCOME MEASURE

Length of hospital stay following surgery.

METHODS

Patients were stratified by having started postoperative PT on the same day as surgery (day zero) or having started postoperative PT on the day following surgery (day one).

RESULTS

A total of 164 patients were included in the study, 69 in the day zero group and 95 patients in the day one group. Most patients were female (59%, n = 98), and patients' average age was 62 years (SD = 13). Average length of stay was 61 hours (SD = 20) for those on the day zero protocol and 75 hours (SD = 32) for those on the day one protocol.

CONCLUSIONS

This study suggests that a postoperative physical therapy protocol initiated on day zero is associated with patients experiencing a shorter length of hospital stay compared to a similar PT protocol initiated on postoperative day one.

The Role of Multiparametric MRI and MRI-targeted Biopsy in Detecting Clinically Significant Prostate Cancer in the Community Setting: A Retrospective Study

Multiparametric MRI and the Prostate Imaging-Reporting and Data System (PI-RADS) have emerged as tools to reveal suspicious prostate lesions and MRI-targeted biopsy has shown potential to avoid repeat prostate biopsies and miss fewer significant cancers. This retrospective study sought to assess the differences in diagnostic yield and sampling efficiency between MRI-targeted and standard biopsies in a community urology practice. We concluded that MRI-targeted biopsy was more efficient than a standard biopsy, although neither technique achieved a superior diagnostic yield of clinically significant cancer in our community setting. We recommend that a standard biopsy be performed alongside targeted biopsy.