Preoperative Functional Mobility as a Predictor of Exceeding the Planned Length of Hospital Stay after Lumbar Fusion Surgery for Spinal Stenosis

Abstract

Objectives: This study aimed to determine the association between preoperative functional mobility and exceeding the planned length of hospital stay (LOS) after lumbar fusion surgery for lumbar spinal stenosis (LSS) and to identify factors associated with preoperative functional mobility.

Methods: A total of 122 patients who underwent lumbar fusion for LSS were included. Preoperative functional mobility was assessed using the Timed Up-and-Go (TUG) test. LOS was categorized as standard (≤14 days) or exceeded (>14 days). Risk ratios (RRs) with 95% confidence intervals (CIs) were estimated using modified Poisson regression to analyze the association between preoperative TUG performance and LOS. Additionally, linear regression was used to identify factors associated with preoperative TUG performance.

Results: In the univariate modified Poisson regression model, exceeding the planned LOS was associated with preoperative TUG performance (RR, 1.10; 95% CI, 1.06 to 1.14; P <0.001). In the adjusted model, this association remained significant (RR, 1.10; 95% CI, 1.06 to 1.14; P <0.001). Poorer preoperative TUG performance was also associated with female sex (mean difference, −2.02 s; 95% CI, −3.60 to −0.43; P = 0.014) and psychiatric comorbidities (mean difference, 7.91 s; 95% CI, 1.95 to 13.87; P = 0.010).

Conclusions: Poorer preoperative functional mobility is an independent predictor of exceeding the planned LOS after lumbar fusion surgery for LSS. Routine preoperative assessment with the TUG test may help identify high-risk patients, and targeted strategies such as enhanced preoperative and postoperative rehabilitation could reduce the likelihood of prolonged hospitalization.