Early mobilisation following elective spine surgery can reduce hospital lengths of stay and complication rate, according to a narrative review published in the journal Healthcare. The study assesses the adoption of enhanced recovery protocols, emphasizing that getting patients to move on surgery day and walk starting the first day after the operation is achievable and ought to be the primary objective.
Evidence for Early Mobilisation in Spine Surgery
According to findings evaluated by researchers at the Orthopaedic Research Institute at Bournemouth University, early mobilisation serves as a cornerstone of Enhanced Recovery after Surgery (ERAS) pathways. The review examined multiple clinical trials and retrospective analyses focusing on elective spinal procedures, including discectomies, decompressions, fusions, and realignment operations.
Data from Musgrove Park Hospital in Taunton, evaluated within the review, demonstrated that implementing a postoperative initiative called “Bums off Beds” helped reduce average patient length of stay from 5.7 days down to 2.7 days. Similarly, a separate retrospective analysis by Bradywood et al. involving non-complex lumbar fusion patients showed that implementing an evidence-based clinical care pathway reduced hospital stays by 0.5 days while increasing the proportion of patients discharged directly home from 64% to 75%.
Clinical Outcomes and Complication Reduction
Beyond shortening hospital stays, early mobilisation protocols correlate with lower rates of specific postoperative complications. According to a study by Chakravarthy et al. involving 799 ERAS patients and 971 control patients undergoing multilevel lumbar or thoracolumbar spinal fusion, structured early movement combined with early urinary catheter removal on postoperative day one reduced surgical site infections from 4.12% in the pre-intervention cohort to 2.00% in the post-intervention group.
Furthermore, perioperative blood transfusion rates in that cohort fell from 20.1% to 7.7%. The review notes that goal-directed protocols typically involve nursing staff or physical therapists assisting patients to sit on the edge of the bed, stand at the bedside, or walk short distances within hours of arriving at a regular nursing floor.
Future Guidelines and Implementation Challenges
Despite positive findings across multiple hospital cohorts, the authors of the Bournemouth University review emphasize that formal, consensus-based guidelines on the optimal prescription of early mobilisation are still lacking. Variability remains regarding the exact timing, frequency, and duration of exercises required for different types of spinal procedures. Subsequent research should strive to formulate agreed-upon, standardized recommendations regarding the ideal methods and scheduling for physical activity, along with adjustments necessary for various spinal operations.
