P96. Postoperative Mobility Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis

BACKGROUND CONTEXT While we council our patients on expected return to activity timelines, patients’ true mobility after posterior spinal fusion (PSF) is not well understood. PURPOSE We sought to utilize a wearable activity tracker to quantitatively describe ambulatory status of patients with adolescent idiopathic scoliosis (AIS) immediately following posterior spinal fusion. STUDY DESIGN/SETTING Patients underwent continuous pre- and postoperative physical activity monitoring via a wearable activity tracker (Fitbit). The patients were recruited during their preoperative clinical visit and the activity monitor was activated. They then wore this monitor continuously until their date of surgery. The activity monitor was removed for surgery and replaced in the Post Anesthesia Care Unit. It was then worn for 3 months postoperatively. Patient reported outcome surveys were obtained throughout their hospital stay as well as at 2 weeks, 6 weeks, and 3 months postoperative. PATIENT SAMPLE We recruited patients aged 10-18 with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF). Patients were excluded if they had non-idiopathic scoliosis, if they were under 10 years of age at the time of surgery, or if their surgery required any anterior fusion or was fusionless. OUTCOME MEASURES Step counts were reported descriptively and tracked continuously from the preoperative visit to 3 months postoperative, excluding the time of surgery. Patient-reported outcomes including the SRS-30 and PROMIS scores as well as pain and health mindset scores were tracked daily while admitted to the hospital as well as 2 weeks, 6 weeks, and 3 months postoperative. METHODS Patients underwent continuous pre- and postoperative physical activity monitoring via a wearable activity tracker (Fitbit). These step count monitors were worn for several weeks preoperatively and 3 months postoperatively. The activity trackers were worn on the wrist throughout the study period and step counts were reported descriptively. A Cox proportional-hazards model was used to analyze the relationship between the time a participant took to return to baseline preoperative step count and the number of levels their surgery included. RESULTS We recruited 17 patients, 11 females (64.7%) and 6 males (35.3%). Mean age at the time of surgery was 14 years (range 12-17 years). There were 15/17 (88%) patients who returned to their baseline mobility within 3 months postoperatively. For the 15 patients that returned to their baseline step count, the mean number of days to return to baseline was 28 days (range 14-32 days). When looking at their maximal per day step count preoperatively and comparing that to postoperative data, the average days to return to maximum daily step count was 48 days (range 33-66 days). The number of spinal levels fused was not found to significantly alter postoperative mobility. There was no correlation between patient reported outcomes and postoperative mobility with the exception of a significant increase in the PROMIS mobility score for patients with a higher step count (p=0.03). CONCLUSIONS There was significant variability in the mobility of our patients after PSF. However, the vast majority of our patients were able to return to their preoperative mobility level within 3 months. With this data, our patients and their families can have a better expectation for postoperative mobility after PSF to set appropriate expectations. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs. While we council our patients on expected return to activity timelines, patients’ true mobility after posterior spinal fusion (PSF) is not well understood. We sought to utilize a wearable activity tracker to quantitatively describe ambulatory status of patients with adolescent idiopathic scoliosis (AIS) immediately following posterior spinal fusion. Patients underwent continuous pre- and postoperative physical activity monitoring via a wearable activity tracker (Fitbit). The patients were recruited during their preoperative clinical visit and the activity monitor was activated. They then wore this monitor continuously until their date of surgery. The activity monitor was removed for surgery and replaced in the Post Anesthesia Care Unit. It was then worn for 3 months postoperatively. Patient reported outcome surveys were obtained throughout their hospital stay as well as at 2 weeks, 6 weeks, and 3 months postoperative. We recruited patients aged 10-18 with adolescent idiopathic scoliosis (AIS) undergoing posterior spinal fusion (PSF). Patients were excluded if they had non-idiopathic scoliosis, if they were under 10 years of age at the time of surgery, or if their surgery required any anterior fusion or was fusionless. Step counts were reported descriptively and tracked continuously from the preoperative visit to 3 months postoperative, excluding the time of surgery. Patient-reported outcomes including the SRS-30 and PROMIS scores as well as pain and health mindset scores were tracked daily while admitted to the hospital as well as 2 weeks, 6 weeks, and 3 months postoperative. Patients underwent continuous pre- and postoperative physical activity monitoring via a wearable activity tracker (Fitbit). These step count monitors were worn for several weeks preoperatively and 3 months postoperatively. The activity trackers were worn on the wrist throughout the study period and step counts were reported descriptively. A Cox proportional-hazards model was used to analyze the relationship between the time a participant took to return to baseline preoperative step count and the number of levels their surgery included. We recruited 17 patients, 11 females (64.7%) and 6 males (35.3%). Mean age at the time of surgery was 14 years (range 12-17 years). There were 15/17 (88%) patients who returned to their baseline mobility within 3 months postoperatively. For the 15 patients that returned to their baseline step count, the mean number of days to return to baseline was 28 days (range 14-32 days). When looking at their maximal per day step count preoperatively and comparing that to postoperative data, the average days to return to maximum daily step count was 48 days (range 33-66 days). The number of spinal levels fused was not found to significantly alter postoperative mobility. There was no correlation between patient reported outcomes and postoperative mobility with the exception of a significant increase in the PROMIS mobility score for patients with a higher step count (p=0.03). There was significant variability in the mobility of our patients after PSF. However, the vast majority of our patients were able to return to their preoperative mobility level within 3 months. With this data, our patients and their families can have a better expectation for postoperative mobility after PSF to set appropriate expectations.