Braking reaction time before and after surgery for patients with recurrent lumbar disc herniation

Restricted access


The positive effect of primary lumbar disc surgery on braking reaction time (BRT) has already been shown. The authors investigated the effect of recurrent lumbar disc herniation surgery on BRT.


Twenty-four patients (mean age 49.9 years) were investigated for BRT 1 day before surgery, postoperatively before hospital discharge, and 4 to 5 weeks after surgery. Thirty-one healthy subjects served as a control group.


Significant improvement of BRT following surgery was found in all patients (p < 0.05). For patients with right-sided recurrent disc herniation, median BRT was 736 msec before surgery, 685 msec immediately postoperatively, and 662 msec at follow-up. For patients with left-sided recurrent disc herniation, median BRT was 674 msec preoperatively, 585 msec postoperatively, and 578 msec at follow-up. Control subjects had a median BRT of 487, which differed significantly from the patient BRTs at all 3 test times (p < 0.05).


A significant reduction in BRT in patients with recurrent disc herniation was found following lumbar disc revision surgery, indicating a positive impact of surgery. Due to the improvement in BRT observed immediately after surgery, we conclude that it is appropriate to recommend that patients keep driving after being discharged from the hospital.

ABBREVIATIONS BRT = braking reaction time; FU = follow-up; VAS = visual analog scale.

Article Information

Correspondence Martin Thaler: Medical University Innsbruck, Austria.

INCLUDE WHEN CITING Published online March 15, 2019; DOI: 10.3171/2019.1.SPINE18859.

Disclosures All authors are paid employees of the Medical University of Innsbruck.

© AANS, except where prohibited by US copyright law.



  • View in gallery

    The custom-built car simulator which was used and validated in previously published reports is shown.1,3 The car simulator consists of a car seat with adjustable seat inclination, head rest, and seat-to-pedal distance to simulate the patient’s favorite position in a car. The seat is mounted on a frame with hanging pedals on rubber-damped pivots. An external box with a green and a red lamp is connected to the measurement system and is used to determine BRT. Figure is available in color online only.



Al-khayer ASchueler AKruszewski GArmstrong GGrevitt MP: Driver reaction time before and after treatment for lumbar radiculopathy. Spine (Phila Pa 1976) 33:169617002008


Byas-Smith MGChapman SLReed BCotsonis G: The effect of opioids on driving and psychomotor performance in patients with chronic pain. Clin J Pain 21:3453522005


Department of Transport: The Highway Code. London: Her Majesty’s Stationery Office1978


Ganz SBLevin AZPeterson MGRanawat CS: Improvement in driving reaction time after total hip arthroplasty. Clin Orthop Relat Res (413):1922002003


Gotlin RSSherman ALSierra NKelly MScott WN: Measurement of brake response time after right anterior cruciate ligament reconstruction. Arthroscopy 16:1511552000


Kim MSPark KWHwang CLee YKKoo KHChang BS: Recurrence rate of lumbar disc herniation after open discectomy in active young men. Spine (Phila Pa 1976) 34:24292009


Liebensteiner MCBirkfellner FThaler MHaid CBach CKrismer M: Driving reaction time before and after primary fusion of the lumbar spine. Spine (Phila Pa 1976) 35:3303352010


Liebensteiner MCKern MHaid CKobel CNiederseer DKrismer M: Brake response time before and after total knee arthroplasty: a prospective cohort study. BMC Musculoskelet Disord 11:2672010


MacDonald WOwen JW: The effect of total hip replacement on driving reactions. J Bone Joint Surg Br 70:2022051988


Marques CJBarreiros JCabri JCarita AIFriesecke CLoehr JF: Does the brake response time of the right leg change after left total knee arthroplasty? A prospective study. Knee 15:2952982008


Papadopoulos ECGirardi FPSandhu HSSama AAParvataneni HKO’Leary PF: Outcome of revision discectomies following recurrent lumbar disc herniation. Spine (Phila Pa 1976) 31:147314762006


Pierson JLEarles DRWood K: Brake response time after total knee arthroplasty: when is it safe for patients to drive? J Arthroplasty 18:8408432003


Royal Automobile Club of Victoria: Average Reaction Braking and Stopping Distances in Metres at Different Speed With Reaction Time of 0.75 Seconds. Melbourne: Royal Automobile Club of Victoria1996


Sabatowski R: [Driving ability under opioids: current assessment of published studies.] Dtsch Med Wochenschr 133 (Suppl 2):S25S282008 (Ger)


Scott PACandler PDLi JC: Stature and seat position as factors affecting fractionated response time in motor vehicle drivers. Appl Ergon 27:4114161996


Spalding TJKiss JKyberd PTurner-Smith ASimpson AH: Driver reaction times after total knee replacement. J Bone Joint Surg Br 76:7547561994


Stokes MYoung A: The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci (Lond) 67:7141984


Suk KSLee HMMoon SHKim NH: Recurrent lumbar disc herniation: results of operative management. Spine (Phila Pa 1976) 26:6726762001


Thaler MLechner RFoedinger BHaid CKavakebi PGaliano K: Driving reaction time before and after surgery for disc herniation in patients with preoperative paresis. Spine J 15:9189222012


Thaler MLechner RFoedinger BHaid CKavakebi PGaliano K: Driving reaction time before and after surgery for lumbar disc herniation in patients with radiculopathy. Eur Spine J 21:225922642012


Triggs TJ: Driver brake reaction times: unobtrusive measurement on public roads. Public Health Rev 15:2752901987




All Time Past Year Past 30 Days
Abstract Views 60 60 60
Full Text Views 20 20 20
PDF Downloads 8 8 8
EPUB Downloads 0 0 0


Google Scholar