Static and Dynamic Balance in Adults Undergoing Lumbar Spine Surgery: Screening and Prediction of Postsurgical Outcomes

Anat V. Lubetzky, Avihai Soroka, Daphna Harel, Thomas Errico, John Bendo, Joseph Leitner, Shay Shabat, Eli Ashkenazi, Yizhar Floman, Marilyn Moffat, Youssef Masharawi

Research output: Contribution to journalArticlepeer-review


INTRODUCTION: Balance and fall risk before and after lumbar surgery was assessed to determine whether balance at baseline predicts long-term postsurgical outcomes. METHODS: Forty-three patients in the United States and Israel performed the single-leg stance (SLS) test, four square step test (FSST), and 8-foot up-and-go (8FUG) test before and 2 to 4 months after lumbar spine surgery. They completed the Oswestry Disability Index (ODI) and pain rating before and 12 months after lumbar surgery. RESULTS: From baseline to follow-up, the SLS time was 3.74 seconds longer (P = 0.01), the FSST time was 1.94 seconds faster (P < 0.001), and the 8FUG time was 1.55 seconds faster (P = 0.02). Before surgery, 26% of the patients were considered high fall risk according to the FSST and 51% according to the 8FUG. Postsurgery, all patients could complete the physical tests, but 26% remained at high fall risk according to the 8FUG and 7.5% according to the FSST. The three physical measures together explained 30% of the variance in postsurgical ODI scores (P = 0.02). Age was not correlated with performance. DISCUSSION: Risk of falling is higher than surgeons suspect. Balance tests (ie, SLS, FSST, and 8FUG) are quick and easy to administer. The findings support the importance of screening for balance and fall risk in adults undergoing lumbar spine surgery.

Original languageEnglish (US)
Pages (from-to)e553-e559
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Issue number13
StatePublished - Jul 1 2020


  • Accidental Falls/prevention & control
  • Adult
  • Aged
  • Diskectomy
  • Humans
  • Low Back Pain/physiopathology
  • Lumbar Vertebrae/physiopathology
  • Male
  • Middle Aged
  • Postoperative Period
  • Postural Balance
  • Predictive Value of Tests
  • Prospective Studies
  • Risk
  • Spinal Fusion
  • Standing Position
  • Time Factors
  • Treatment Outcome

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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