Effect of same-day physical therapy on length of hospital stay and discharge disposition following single-level lumbar fusion.

Abstract

OBJECTIVE: The aim of the study was to evaluate the safety and efficacy of initiating physical therapy (PT) on the day of surgery (i.e., postoperative day 0 [POD0]) in patients undergoing single-level lumbar fusion surgery, with a focus on hospital length of stay (LOS) and early postoperative outcomes. METHODS: The authors conducted a retrospective review of prospectively collected data from a single institution. Patients undergoing single-level lumbar fusion between August 2022 and December 2024 were included. Those with revision surgery, tumors, or infections were excluded. POD0 PT was implemented in January 2024. Patients treated prior to this date received POD1 PT. Demographic, surgical, and postoperative data were compared between the POD0 and POD1 PT groups. RESULTS: A total of 586 patients were analyzed (POD0, n = 84; POD1, n = 502). Baseline demographics and surgical characteristics were similar between the groups. The POD0 group had a significantly shorter LOS (mean 3.4 ± 1.6 vs 4.0 ± 2.7 days, p = 0.016), and the patients were more likely to be discharged home. No significant differences were found in postoperative complications, including cardiac, pulmonary, neurological, gastrointestinal, urinary, infectious, or mechanical issues. Rates of 30- and 90-day emergency department visits, readmissions, or reoperations were also comparable between the groups. CONCLUSIONS: Initiating PT on the day of surgery is associated with reduced LOS and an increased likelihood of home discharge, without increasing complications or worsening clinical outcomes. These findings support the safety and potential benefits of POD0 PT in enhancing early recovery following single-level lumbar fusion surgery.