Affiliations: [a] Department of Orthopaedic Surgery, University Hospital of Tübingen, Tübingen, Germany | [b] Department of Dermatology, Tübingen, Germany | [c] Division of Neuropsychology, Hertie Institute for Clinical Brain Research, Tübingen, Germany | [d] Institute for Medical Statistics and Epidemiology, University Hospital of the Technische Universität München, München, Germany | [e] MVZ Straubing, Straubing, Germany
Correspondence:
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Corresponding author: Ulf K. Hofmann, Department of Orthopaedic Surgery, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, D-72076 Tübingen, Germany. Tel.: +49 (0)7071 2986685; E-mail: [email protected].
Abstract: BACKGROUND: Spinal surgeries have strongly increased in number over the past decade. The question of when it is safe to resume driving is thereby one the most frequently asked questions that patients ask of their treating physician. OBJECTIVE: The aim of this study was to assess braking performance before and after spine surgery. METHODS: Reaction time, foot transfer time (together brake response time [BRT]), and brake force (BF) were evaluated in a drive simulator. A longitudinal patient cohort (n= 27) was tested preoperatively and at the first follow-up. A cross-sectional cohort (n= 27) was tested at > 1 year postoperatively. The values from these groups were compared with a healthy age-matched control group of 24 volunteers. RESULTS: No significant improvement in BRT was seen in lumbar fusion three months postoperatively (p= 0.597); BF was even weaker than it was preoperatively (p= 0.044). In comparison to the control group (median BRT 479 ms), preoperative BRT was already impaired in lumbar fusion patients (median 560 ms), representing an increased braking distance of 2.25 m at 100 km/h. CONCLUSION: Although most patients performed adequately, about one third presented critical braking performance. Risk factors for impaired braking may include scheduled multisegmental fusion surgery, female sex, and pain.
Keywords: Total brake response time, driver reaction time, driving reaction time, lumbar fusion, nucleotomy, lumbar decompression
