Observer-reported outcome measures showed that patients ’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm .
Conclusions The available evidence provides a best-case scenario for when patients can return to driving .
Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized , indicating that physicians should tell patients to wait longer before driving .
Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures , but the data regarding this topic are diverse and sometimes conflicting .
Some studies provide observer-reported outcome measures , such as brake response time or simulators , to estimate when patients can safely resume driving after surgery , and patient survey data describing when patients report a return to driving , but they do not all agree .
We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive .
Questions / purpose sBased on the available evidence , we sought to determine when patients can safely return to driving after ( 1 ) lower extremity orthopaedic surgery and injuries ; ( 2 ) upper extremity orthopaedic surgery and injuries ; and ( 3 ) spine surgery .
Driving Reaction Time Before and After Primary Fusion of the Lumbar Spine
Study Design . Controlled prospect i ve study . Objective . To determine whether driving reaction time ( DRT ) is influenced by primary lumbar fusion . Summary of Background Data . The effects of radiculopathy and nerve root blocks on DRT have been reported recently . To our knowledge , the relationship between lumbar fusion and DRT has not been previously studied although it is important for driving safety . The aim of the present study was to test the hypotheses that DRT after lumbar fusion is ( 1 ) altered after the operation , ( 2 ) influenced by pain , ( 3 ) influenced by the patient 's driving skill , and ( 4 ) differs from the DRT of healthy controls . Methods . Twenty-one consecutive patients ( mean age , 53.5 years ; SD 10.8 ) receiving primary lumbar fusion were tested for their DRT 1 day before surgery ( preoperative ) , the day before discharge ( postoperative ) and 3 months after surgery ( follow-up ; FU ) .  DRT  was assessed using a custom-made driving simulator . The severity of back pain was determined on visual analogue scales separately for usual pain ( VAS-U ) and pain during testing ( VAS-T ) . We also determined the patients ' subjective driving frequency . Normative DRT data from 31 age-matched healthy controls were used for comparison . Results . The preoperative DRT was 685 milliseconds ( Md ; IQR 246 ) and the postoperative DRT 728 milliseconds ( Md ; IQR 264 ) , which was further reduced to 671 milliseconds ( Md ; IQR 202 ) after the FU period . Statistical significance was registered between postoperative and FU DRT ( P = 0.007 ) . Moderate to high correlations ( 0.537 < r < 0.680 ) were found between the VAS rating of back pain and DRT . Control subjects had a DRT of 487 milliseconds ( Md ; IQR 116 ) , which differed significantly from the DRT of patients at all 3 time points of testing ( P < 0.001 ) . Conclusion . It appears safe to continue driving after discharge from the hospital following lumbar fusion . DRT improved significantly during FU , indicating a positive effect of the intervention on driving skills . DRT correlates with the severity of back pain
Observer-reported outcome measures showed that patients ’ driving abilities often are impaired when wearing an immobilizing cast above or below the elbow or a shoulder sling on their dominant arm .
Conclusions The available evidence provides a best-case scenario for when patients can return to driving .
Survey data suggest that patients are returning to driving before observer-reported outcome measures have normalized , indicating that physicians should tell patients to wait longer before driving .
Background Patients often ask their doctors when they can safely return to driving after orthopaedic injuries and procedures , but the data regarding this topic are diverse and sometimes conflicting .
Some studies provide observer-reported outcome measures , such as brake response time or simulators , to estimate when patients can safely resume driving after surgery , and patient survey data describing when patients report a return to driving , but they do not all agree .
We performed a systematic review and quality appraisal for available data regarding when patients are safe to resume driving after common orthopaedic surgeries and injuries affecting the ability to drive .
Questions / purpose sBased on the available evidence , we sought to determine when patients can safely return to driving after ( 1 ) lower extremity orthopaedic surgery and injuries ; ( 2 ) upper extremity orthopaedic surgery and injuries ; and ( 3 ) spine surgery .