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General Rehabilitation

Functional Predictors of Discharge Destination after Elective Spine Fusion

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 7
Disclosure(s):
Gayle R. Spill, MD: No financial relationships to disclose
Daniel A. Goodman, MD: No financial relationships to disclose
Sharon Woo, DO: No financial relationships to disclose
Background and/or Objectives: Spinal fusion is a widely-performed surgical procedure that is commonly used for the treatment of chronic pain due to spondylosis. Rates have increased significantly in recent years in the setting of an aging population. While the procedure aims to improve spinal stability and reduce pain, the recovery trajectory varies considerably among patients. Our study aims to identify key functional predictors associated with whether patients who have undergone elective spinal fusion will require acute inpatient rehabilitation or can safely discharge home.

Design: Retrospective case-control study.

Setting : Acute care hospital.

Participants : 64 adult patients admitted to an acute care hospital for elective cervical or lumbar fusion surgery.

Interventions: Not applicable.

Main Outcome Measures: Patient and mobility factors associated with discharge destination.

Results: 31% of patients discharged home (n=20) and 69% of patients discharged to IRF (n=44). Patients discharged to IRF were older (70% of patients were >65 years of age vs. 45% of patients discharged home), had greater number of vertebrae fused (73% had >4 levels fused vs. 50% of patients discharged home), and ambulated shorter distances postoperatively (5% of patients ambulated >40 feet vs. 50% of patients discharged home). In the multivariate analysis, increased ambulation distance was independently associated with a reduced likelihood of discharge to IRF (OR=0.94; CI, 0.89 to 0.97). Ability to ambulate greater than 40 feet on initial evaluation was strongly associated with a reduced likelihood of discharge to IRF (OR=0.10; CI, 0.02 to 0.48).

Conclusions: Ambulation distance can be a valuable predictor for discharge planning, as patients who ambulate greater distances immediately after surgery have significantly decreased odds of requiring discharge to IRF. By addressing this gap in knowledge, our findings may contribute to the development of standardized assessment criteria for appropriate consultation of a Physical Medicine and Rehabilitation physician. Establishing objective predictors of rehabilitation could help guide clinical decision-making and streamline postoperative care pathways.