Disability after lumbar spine surgery in a Peruvian rehabilitation setting: A cross-sectional study using the Roland-Morris Questionnaire and Oswestry Disability Index
Roger De La Cerna-Luna1, David Aparicio-Farfan2, Fiorella Mendoza-Cabrera1, Nives Santayana-Calisaya1, Paula Arnillas Brigneti1, Miguel Cabanillas-Lazo3
sup>1Department of Physical Medicine and Rehabilitation, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
2Policlínico Juan José Rodríguez Lazo, EsSalud, Lima, Peru
3Grupo de Investigación Neurociencias, Metabolismo, Efectividad Clínica Y Sanitaria (NEMECS), Universidad Científica del Sur, Lima, Peru
Keywords: Disability, lumbosacral region, Peru, rehabilitation, surgical procedures.
Abstract
Objectives: This study aims to evaluate functional disability using the Roland-Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) as complementary patient-reported outcome measures and to explore their associations with clinical characteristics, work disability, and rehabilitation service utilization among patients receiving postoperative rehabilitation after lumbar spine surgery (LSS).
Patients and methods: During September 2025, a total of 63 adult patients with a history of LSS enrolled in a spine rehabilitation program were included in this cross-sectional, observational study. Sociodemographic, clinical, functional-disability, work-disability, and rehabilitation service-utilization data were recorded. Functional-disability was assessed using the RMDQ and ODI. Pain severity was evaluated using the Visual Analog Scale (VAS).
Results: Of the patients, 29 were male and 34 were female with a median age of 58 (IQR, 51 to 63) years. The median level of work intensity was 3 (range, 2-4). Median pain severity was 6 (range, 4-7). Significant functional-disability was identified in 65.1% of patients using RMDQ and 92.1% using ODI. Median rehabilitation program length of stay was 689 days, and median accumulated work-disability time was 254 days. According to RMDQ, vertebral fracture was more common among patients without significant functional-disability (27.3% vs. 4.9%; p = 0.018), whereas lower-limb pain radiation was more frequent among those with significant functional-disability (63.4% vs. 31.8%; p = 0.017). Rehabilitation service-utilization did not differ significantly between RMDQ-defined groups. Based on ODI, accumulated work-disability time was significantly greater among patients with significant functional-disability (median 554 vs. 218 days; p = 0.012), while no other variables differed significantly (p > 0.05).
Conclusion: Significant functional-disability is highly prevalent among LSS patients receiving rehabilitation, particularly when assessed with ODI, and is usually accompanied by prolonged work-disability. Lower-limb pain radiation is associated with greater functional-disability, whereas rehabilitation service-utilization is not associated with lower functional-disability. These findings support the development of targeted multidisciplinary rehabilitation strategies to optimize postoperative recovery after LSS.