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.