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.	Lindbäck 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, 陈为国. 七氟烷复合右美托咪定在伴有轻度认知障碍老年腰椎手术患者中的应用效果. 中国老年学杂志, 2024, 44(11): 2621-2624.
5.	王天龙. 老年骨科患者麻醉管理的临床实践与创新. 中国脊柱脊髓杂志, 2024, 34(6): 669-672.
6.	顾海燕, 宣沁, 王婷婷, 等. 院前预康复在老年腰椎后路长节段手术患者中的应用. 中国护理管理, 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 Skořepa, Gomez D, et al. Prehabilitation: high-quality evidence is still required. Br J Anaesth, 2023, 130(1): 9-14.
9.	张志成, 杜培, 孟浩, 等. 腰椎后路短节段手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 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.	张杨西贝, 柏彬, 马杰, 等. 基于加速康复外科理念的术前护理干预模式在老年腰椎管狭窄症手术患者中的应用研究. 中华全科医学, 2021, 19(12): 2146-2148,2157.
15.	郭卿, 刘会玲, 李身泰, 等. 基于运动疗法的预康复在腰椎间盘突出症手术患者中的应用研究. 现代中西医结合杂志, 2023, 32(20): 2902-2905.
16.	臧丽华. 术前共情沟通联合术中非语言交流在腰椎间盘突出行经皮椎间孔镜治疗中的应用. 国际护理学杂志, 2018, 37(4): 545-547.
17.	秦芳, 周金莉, 王涵, 等. 术前预康复方案在腰椎退行性疾病手术患者中的应用. 中国护理管理, 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, Jørgensen 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.	Kesänen 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.	Strøm J, Nielsen CV, Jørgensen 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.	Lindbäck 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.	刘采群, 唐成剑, 周长征, 等. 腹式呼吸训练联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、肺功能及腰部姿势控制能力的影响. 现代生物医学进展, 2024, 24(1): 101-105.
38.	张丰健, 陈成, 张宁, 等. 胰腺癌患者运动干预的范围综述. 护理学杂志, 2023, 38(20): 116-121.
39.	彭涛, 何永琴, 易德坤, 等. 术前运动训练在老年髋部骨折患者预康复中应用的范围综述. 华西医学, 2024, 39(6): 906-912.
40.	刘子嘉, 张路, 刘洪生, 等. 基于加速术后康复的胸外科手术预康复管理专家共识(2022). 协和医学杂志, 2022, 13(3): 387-401.
41.	倪蓓君, 伍铜锤, 匡留洋, 等. 医护一体化加速康复外科护理在脊柱外科手术患者中的应用价值. 医学新知, 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. Lindbäck 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, 陈为国. 七氟烷复合右美托咪定在伴有轻度认知障碍老年腰椎手术患者中的应用效果. 中国老年学杂志, 2024, 44(11): 2621-2624.
5. 王天龙. 老年骨科患者麻醉管理的临床实践与创新. 中国脊柱脊髓杂志, 2024, 34(6): 669-672.
6. 顾海燕, 宣沁, 王婷婷, 等. 院前预康复在老年腰椎后路长节段手术患者中的应用. 中国护理管理, 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 Skořepa, Gomez D, et al. Prehabilitation: high-quality evidence is still required. Br J Anaesth, 2023, 130(1): 9-14.
9. 张志成, 杜培, 孟浩, 等. 腰椎后路短节段手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 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. 张杨西贝, 柏彬, 马杰, 等. 基于加速康复外科理念的术前护理干预模式在老年腰椎管狭窄症手术患者中的应用研究. 中华全科医学, 2021, 19(12): 2146-2148,2157.
15. 郭卿, 刘会玲, 李身泰, 等. 基于运动疗法的预康复在腰椎间盘突出症手术患者中的应用研究. 现代中西医结合杂志, 2023, 32(20): 2902-2905.
16. 臧丽华. 术前共情沟通联合术中非语言交流在腰椎间盘突出行经皮椎间孔镜治疗中的应用. 国际护理学杂志, 2018, 37(4): 545-547.
17. 秦芳, 周金莉, 王涵, 等. 术前预康复方案在腰椎退行性疾病手术患者中的应用. 中国护理管理, 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, Jørgensen 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. Kesänen 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. Strøm J, Nielsen CV, Jørgensen 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. Lindbäck 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. 刘采群, 唐成剑, 周长征, 等. 腹式呼吸训练联合腰部核心肌力训练对腰椎间盘突出症患者腰椎功能、肺功能及腰部姿势控制能力的影响. 现代生物医学进展, 2024, 24(1): 101-105.
38. 张丰健, 陈成, 张宁, 等. 胰腺癌患者运动干预的范围综述. 护理学杂志, 2023, 38(20): 116-121.
39. 彭涛, 何永琴, 易德坤, 等. 术前运动训练在老年髋部骨折患者预康复中应用的范围综述. 华西医学, 2024, 39(6): 906-912.
40. 刘子嘉, 张路, 刘洪生, 等. 基于加速术后康复的胸外科手术预康复管理专家共识(2022). 协和医学杂志, 2022, 13(3): 387-401.
41. 倪蓓君, 伍铜锤, 匡留洋, 等. 医护一体化加速康复外科护理在脊柱外科手术患者中的应用价值. 医学新知, 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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