Prehabilitation in patients undergoing surgery for lumbar degenerative disease: a scoping review_West China Medical Journal

Authors：

GENG Xinyan ¹ , WEN Xiaochen ¹ , XIA Xiaoyan ² , WANG Bingwu ² , LI Siying ³ ,  ZHENG Hongwei ⁴

1. School of Nursing, Shandong Second Medical University, Weifang, Shandong 261000, P. R. China;
2. Department of Spine and Orthopedic Surgery, Weifang People’s Hospital, Weifang, Shandong 261000, P. R. China;
3. Department of Spinal Degeneration and Oncology, Weifang People’s Hospital, Weifang, Shandong 261000, P. R. China;
4. Department of Anesthesia, Weifang People’s Hospital, Weifang, Shandong 261000, P. R. China;

Corresponding?author：

ZHENG Hongwei, Email: yishenglzq@163.com

Keywords：

Lumbar spine surgery; lumbar degenerative disease; prehabilitation; scoping review

DOI：

10.7507/1002-0179.202410111

Video：

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Objective To analyze the application research of prehabilitation in patients with lumbar degenerative spine surgery, and to review the intervention content, outcome index, and applied effect of prehabilitation of lumbar spine surgery patients, to provide references for the future clinical development of related research. Methods Guided by the methodology of scope review, systematic searches were conducted on China National Knowledge Infrastructure, Wanfang Database, VIP, China Biomedical Literature Database, PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases from the establishment of the database to June 2024, and the included literature was screened, refined and summarized. Results A total of 21 papers were included, including 15 randomized controlled trials, 5 quasi-experimental studies, and 1 retrospective study. The main components of prehabilitation included exercise, preoperative psychological support, nutritional interventions, and multiform health education; and the main outcome indicators included pain, assessment of low back function, sleep quality, anxiety and depression, and healthy quality of life.Conclusion Preoperative prehabilitation has a positive effect on patients undergoing surgery for lumbar degenerative disease, and the existing studies are heterogeneous in terms of content and outcome indicators, and the follow-up should continue to construct a more scientific and multimodal intervention program and carry out large-scale high-quality studies.

Citation： GENG Xinyan, WEN Xiaochen, XIA Xiaoyan, WANG Bingwu, LI Siying, ZHENG Hongwei. Prehabilitation in patients undergoing surgery for lumbar degenerative disease: a scoping review. West China Medical Journal, 2025, 40(6): 901-906. doi: 10.7507/1002-0179.202410111 Copy

1.	Kim HS, Wu PH, Jang IT. Lumbar degenerative disease part 1: anatomy and pathophysiology of intervertebral discogenic pain and radiofrequency ablation of basivertebral and sinuvertebral nerve treatment for chronic discogenic back pain: a prospective case series and review of literature. Int J Mol Sci, 2020, 21(4): 1483.
2.	Ravindra VM, Senglaub SS, Rattani A, et al. Degenerative lumbar spine disease: estimating global incidence and worldwide volume. Global Spine J, 2018, 8(8): 784-794.
3.	Lindb?ck Y, Tropp H, Enthoven P, et al. PREPARE: pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol. BMC Musculoskelet Disord, 2016, 17: 270.
4.	丁荷蓓, 王珣, 陳為國. 七氟烷復合右美托咪定在伴有輕度認知障礙老年腰椎手術患者中的應用效果. 中國老年學雜志, 2024, 44(11): 2621-2624.
5.	王天龍. 老年骨科患者麻醉管理的臨床實踐與創新. 中國脊柱脊髓雜志, 2024, 34(6): 669-672.
6.	顧海燕, 宣沁, 王婷婷, 等. 院前預康復在老年腰椎后路長節段手術患者中的應用. 中國護理管理, 2023, 23(1): 57-62.
7.	Le Roy B, Slim K. Is prehabilitation limited to preoperative exercise?. Surgery, 2017, 162(1): 192.
8.	Lobo DN, Pavel Sko?epa, Gomez D, et al. Prehabilitation: high-quality evidence is still required. Br J Anaesth, 2023, 130(1): 9-14.
9.	張志成, 杜培, 孟浩, 等. 腰椎后路短節段手術加速康復外科實施流程專家共識. 中華骨與關節外科雜志, 2019, 12(6): 401-409.
10.	Punnoose A, Claydon-Mueller LS, Weiss O, et al. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA Netw Open, 2023, 6(4): e238050.
11.	Toohey K, Hunter M, McKinnon K, et al. A systematic review of multimodal prehabilitation in breast cancer. Breast Cancer Res Treat, 2023, 197(1): 1-37.
12.	Konnyu KJ, Thoma LM, Cao W, et al. Prehabilitation for total knee or total hip arthroplasty: a systematic review. Am J Phys Med Rehabil, 2023, 102(1): 1-10.
13.	Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
14.	張楊西貝, 柏彬, 馬杰, 等. 基于加速康復外科理念的術前護理干預模式在老年腰椎管狹窄癥手術患者中的應用研究. 中華全科醫學, 2021, 19(12): 2146-2148,2157.
15.	郭卿, 劉會玲, 李身泰, 等. 基于運動療法的預康復在腰椎間盤突出癥手術患者中的應用研究. 現代中西醫結合雜志, 2023, 32(20): 2902-2905.
16.	臧麗華. 術前共情溝通聯合術中非語言交流在腰椎間盤突出行經皮椎間孔鏡治療中的應用. 國際護理學雜志, 2018, 37(4): 545-547.
17.	秦芳, 周金莉, 王涵, 等. 術前預康復方案在腰椎退行性疾病手術患者中的應用. 中國護理管理, 2022, 22(9): 1433-1437.
18.	Janssen ERC, Punt IM, Biemans CFM, et al. Preoperative community based functional high intensity interval training (f-HIIT) with high-risk patients opting for lumbar spinal fusion: a pilot study. Disabil Rehabil, 2023, 45(5): 805-813.
19.	Eubanks JE, Cupler ZA, Gliedt JA, et al. Preoperative spinal education for lumbar spinal stenosis: a feasibility study. PM R, 2024, 16(9): 992-1000.
20.	Nielsen PR, J?rgensen LD, Dahl B, et al. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial. Clin Rehabil, 2010, 24(2): 137-148.
21.	Nielsen PR, Andreasen J, Asmussen M, et al. Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine. BMC Health Serv Res, 2008, 8: 209.
22.	Lotzke H, Brisby H, Gutke A, et al. A person-centered prehabilitation program based on cognitive-behavioral physical therapy for patients scheduled for lumbar fusion surgery: a randomized controlled trial. Phys Ther, 2019, 99(8): 1069-1088.
23.	Fors M, Enthoven P, Abbott A, et al. Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: secondary outcomes of the PREPARE randomised controlled trial. BMC Musculoskelet Disord, 2019, 20(1): 468.
24.	Kes?nen J, Leino-Kilpi H, Lund T, et al. The Knowledge Test Feedback Intervention (KTFI) increases knowledge level of spinal stenosis patients before operation-a randomized controlled follow-up trial. Patient Educ Couns, 2016, 99(12): 1984-1991.
25.	Str?m J, Nielsen CV, J?rgensen LB, et al. A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial. Spine J, 2019, 19(5): 827-839.
26.	Eastwood D, Manson N, Bigney E, et al. Improving postoperative patient reported benefits and satisfaction following spinal fusion with a single preoperative education session. Spine J, 2019, 19(5): 840-845.
27.	Marchand AA, Suitner M, O’Shaughnessy J, et al. Feasibility of conducting an active exercise prehabilitation program in patients awaiting spinal stenosis surgery: a randomized pilot study. Sci Rep, 2019, 9(1): 12257.
28.	Marchand AA, Houle M, O'Shaughnessy J, et al. Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical tria. Sci Rep, 2021, 11(1): 11080.
29.	Rolving N, Nielsen CV, Christensen FB, et al. Does a preoperative cognitive-behavioral intervention affect disability, pain behavior, pain, and return to work the first year after lumbar spinal fusion surgery?. Spine (Phila Pa 1976), 2015, 40(9): 593-600.
30.	Rolving N, Nielsen CV, Christensen FB, et al. Preoperative cognitive-behavioural intervention improves in-hospital mobilisation and analgesic use for lumbar spinal fusion patients. BMC Musculoskelet Disord, 2016, 17: 217.
31.	Yi JL, Porucznik CA, Gren LH, et al. The impact of preoperative mindfulness-based stress reduction on postoperative patient-reported pain, disability, quality of life, and prescription opioid use in lumbar spine degenerative disease: a pilot study. World Neurosurg, 2019, 121: e786-e791.
32.	Scarone P, Smeets AYJM, van Kuijk SMJ, et al. A randomized controlled TRIal of cognitive BEhavioral therapy for high catastrophizing in patients undergoing lumbar fusion surgery: the TRIBECA study. BMC Musculoskelet Disord, 2020, 21(1): 810.
33.	Lindb?ck Y, Tropp H, Enthoven P, et al. PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial. Spine J, 2018, 18(8): 1347-1355.
34.	Briguglio M, Wainwright TW, Lombardi G. Definition of malnutrition from routinely-collected data for orthopedic surgery research: the global leadership initiative on malnutrition (GLIM) tool and others. Front Nutr, 2023, 10: 1200049.
35.	Briguglio M, Wainwright TW. Nutritional and physical prehabilitation in elective orthopedic surgery: rationale and proposal for implementation. Ther Clin Risk Manag, 2022, 18: 21-30.
36.	Briguglio M. The burdens of orthopedic patients and the value of the hepas approach (healthy eating, physical activity, and sleep hygiene). Front Med (Lausanne), 2021, 8: 650947.
37.	劉采群, 唐成劍, 周長征, 等. 腹式呼吸訓練聯合腰部核心肌力訓練對腰椎間盤突出癥患者腰椎功能、肺功能及腰部姿勢控制能力的影響. 現代生物醫學進展, 2024, 24(1): 101-105.
38.	張豐健, 陳成, 張寧, 等. 胰腺癌患者運動干預的范圍綜述. 護理學雜志, 2023, 38(20): 116-121.
39.	彭濤, 何永琴, 易德坤, 等. 術前運動訓練在老年髖部骨折患者預康復中應用的范圍綜述. 華西醫學, 2024, 39(6): 906-912.
40.	劉子嘉, 張路, 劉洪生, 等. 基于加速術后康復的胸外科手術預康復管理專家共識(2022). 協和醫學雜志, 2022, 13(3): 387-401.
41.	倪蓓君, 伍銅錘, 匡留洋, 等. 醫護一體化加速康復外科護理在脊柱外科手術患者中的應用價值. 醫學新知, 2025, 35(5): 512-519.

1. Kim HS, Wu PH, Jang IT. Lumbar degenerative disease part 1: anatomy and pathophysiology of intervertebral discogenic pain and radiofrequency ablation of basivertebral and sinuvertebral nerve treatment for chronic discogenic back pain: a prospective case series and review of literature. Int J Mol Sci, 2020, 21(4): 1483.
2. Ravindra VM, Senglaub SS, Rattani A, et al. Degenerative lumbar spine disease: estimating global incidence and worldwide volume. Global Spine J, 2018, 8(8): 784-794.
3. Lindb?ck Y, Tropp H, Enthoven P, et al. PREPARE: pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol. BMC Musculoskelet Disord, 2016, 17: 270.
4. 丁荷蓓, 王珣, 陳為國. 七氟烷復合右美托咪定在伴有輕度認知障礙老年腰椎手術患者中的應用效果. 中國老年學雜志, 2024, 44(11): 2621-2624.
5. 王天龍. 老年骨科患者麻醉管理的臨床實踐與創新. 中國脊柱脊髓雜志, 2024, 34(6): 669-672.
6. 顧海燕, 宣沁, 王婷婷, 等. 院前預康復在老年腰椎后路長節段手術患者中的應用. 中國護理管理, 2023, 23(1): 57-62.
7. Le Roy B, Slim K. Is prehabilitation limited to preoperative exercise?. Surgery, 2017, 162(1): 192.
8. Lobo DN, Pavel Sko?epa, Gomez D, et al. Prehabilitation: high-quality evidence is still required. Br J Anaesth, 2023, 130(1): 9-14.
9. 張志成, 杜培, 孟浩, 等. 腰椎后路短節段手術加速康復外科實施流程專家共識. 中華骨與關節外科雜志, 2019, 12(6): 401-409.
10. Punnoose A, Claydon-Mueller LS, Weiss O, et al. Prehabilitation for patients undergoing orthopedic surgery: a systematic review and meta-analysis. JAMA Netw Open, 2023, 6(4): e238050.
11. Toohey K, Hunter M, McKinnon K, et al. A systematic review of multimodal prehabilitation in breast cancer. Breast Cancer Res Treat, 2023, 197(1): 1-37.
12. Konnyu KJ, Thoma LM, Cao W, et al. Prehabilitation for total knee or total hip arthroplasty: a systematic review. Am J Phys Med Rehabil, 2023, 102(1): 1-10.
13. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
14. 張楊西貝, 柏彬, 馬杰, 等. 基于加速康復外科理念的術前護理干預模式在老年腰椎管狹窄癥手術患者中的應用研究. 中華全科醫學, 2021, 19(12): 2146-2148,2157.
15. 郭卿, 劉會玲, 李身泰, 等. 基于運動療法的預康復在腰椎間盤突出癥手術患者中的應用研究. 現代中西醫結合雜志, 2023, 32(20): 2902-2905.
16. 臧麗華. 術前共情溝通聯合術中非語言交流在腰椎間盤突出行經皮椎間孔鏡治療中的應用. 國際護理學雜志, 2018, 37(4): 545-547.
17. 秦芳, 周金莉, 王涵, 等. 術前預康復方案在腰椎退行性疾病手術患者中的應用. 中國護理管理, 2022, 22(9): 1433-1437.
18. Janssen ERC, Punt IM, Biemans CFM, et al. Preoperative community based functional high intensity interval training (f-HIIT) with high-risk patients opting for lumbar spinal fusion: a pilot study. Disabil Rehabil, 2023, 45(5): 805-813.
19. Eubanks JE, Cupler ZA, Gliedt JA, et al. Preoperative spinal education for lumbar spinal stenosis: a feasibility study. PM R, 2024, 16(9): 992-1000.
20. Nielsen PR, J?rgensen LD, Dahl B, et al. Prehabilitation and early rehabilitation after spinal surgery: randomized clinical trial. Clin Rehabil, 2010, 24(2): 137-148.
21. Nielsen PR, Andreasen J, Asmussen M, et al. Costs and quality of life for prehabilitation and early rehabilitation after surgery of the lumbar spine. BMC Health Serv Res, 2008, 8: 209.
22. Lotzke H, Brisby H, Gutke A, et al. A person-centered prehabilitation program based on cognitive-behavioral physical therapy for patients scheduled for lumbar fusion surgery: a randomized controlled trial. Phys Ther, 2019, 99(8): 1069-1088.
23. Fors M, Enthoven P, Abbott A, et al. Effects of pre-surgery physiotherapy on walking ability and lower extremity strength in patients with degenerative lumbar spine disorder: secondary outcomes of the PREPARE randomised controlled trial. BMC Musculoskelet Disord, 2019, 20(1): 468.
24. Kes?nen J, Leino-Kilpi H, Lund T, et al. The Knowledge Test Feedback Intervention (KTFI) increases knowledge level of spinal stenosis patients before operation-a randomized controlled follow-up trial. Patient Educ Couns, 2016, 99(12): 1984-1991.
25. Str?m J, Nielsen CV, J?rgensen LB, et al. A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial. Spine J, 2019, 19(5): 827-839.
26. Eastwood D, Manson N, Bigney E, et al. Improving postoperative patient reported benefits and satisfaction following spinal fusion with a single preoperative education session. Spine J, 2019, 19(5): 840-845.
27. Marchand AA, Suitner M, O’Shaughnessy J, et al. Feasibility of conducting an active exercise prehabilitation program in patients awaiting spinal stenosis surgery: a randomized pilot study. Sci Rep, 2019, 9(1): 12257.
28. Marchand AA, Houle M, O'Shaughnessy J, et al. Effectiveness of an exercise-based prehabilitation program for patients awaiting surgery for lumbar spinal stenosis: a randomized clinical tria. Sci Rep, 2021, 11(1): 11080.
29. Rolving N, Nielsen CV, Christensen FB, et al. Does a preoperative cognitive-behavioral intervention affect disability, pain behavior, pain, and return to work the first year after lumbar spinal fusion surgery?. Spine (Phila Pa 1976), 2015, 40(9): 593-600.
30. Rolving N, Nielsen CV, Christensen FB, et al. Preoperative cognitive-behavioural intervention improves in-hospital mobilisation and analgesic use for lumbar spinal fusion patients. BMC Musculoskelet Disord, 2016, 17: 217.
31. Yi JL, Porucznik CA, Gren LH, et al. The impact of preoperative mindfulness-based stress reduction on postoperative patient-reported pain, disability, quality of life, and prescription opioid use in lumbar spine degenerative disease: a pilot study. World Neurosurg, 2019, 121: e786-e791.
32. Scarone P, Smeets AYJM, van Kuijk SMJ, et al. A randomized controlled TRIal of cognitive BEhavioral therapy for high catastrophizing in patients undergoing lumbar fusion surgery: the TRIBECA study. BMC Musculoskelet Disord, 2020, 21(1): 810.
33. Lindb?ck Y, Tropp H, Enthoven P, et al. PREPARE: presurgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial. Spine J, 2018, 18(8): 1347-1355.
34. Briguglio M, Wainwright TW, Lombardi G. Definition of malnutrition from routinely-collected data for orthopedic surgery research: the global leadership initiative on malnutrition (GLIM) tool and others. Front Nutr, 2023, 10: 1200049.
35. Briguglio M, Wainwright TW. Nutritional and physical prehabilitation in elective orthopedic surgery: rationale and proposal for implementation. Ther Clin Risk Manag, 2022, 18: 21-30.
36. Briguglio M. The burdens of orthopedic patients and the value of the hepas approach (healthy eating, physical activity, and sleep hygiene). Front Med (Lausanne), 2021, 8: 650947.
37. 劉采群, 唐成劍, 周長征, 等. 腹式呼吸訓練聯合腰部核心肌力訓練對腰椎間盤突出癥患者腰椎功能、肺功能及腰部姿勢控制能力的影響. 現代生物醫學進展, 2024, 24(1): 101-105.
38. 張豐健, 陳成, 張寧, 等. 胰腺癌患者運動干預的范圍綜述. 護理學雜志, 2023, 38(20): 116-121.
39. 彭濤, 何永琴, 易德坤, 等. 術前運動訓練在老年髖部骨折患者預康復中應用的范圍綜述. 華西醫學, 2024, 39(6): 906-912.
40. 劉子嘉, 張路, 劉洪生, 等. 基于加速術后康復的胸外科手術預康復管理專家共識(2022). 協和醫學雜志, 2022, 13(3): 387-401.
41. 倪蓓君, 伍銅錘, 匡留洋, 等. 醫護一體化加速康復外科護理在脊柱外科手術患者中的應用價值. 醫學新知, 2025, 35(5): 512-519.

West China Medical Journal

Prehabilitation in patients undergoing surgery for lumbar degenerative disease: a scoping review

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