Driver reaction time before and after treatment for lumbar radiculopathy

Abstract

Study design: Prospective observational pilot study. OBJECTIVE.: To investigate the effect of right and left radiculopathy on driver reaction time (DRT), and the effect of selective nerve root block (SNRB) on DRT.

Summary of background data: The effect of many orthopedic procedures on DRT has already been assessed. To date the effect of radiculopathy and SNRB on DRT has not been studied.

Methods: DRTs of 20 radiculopathic patients (10 right, 10 left) were measured using a custom-built car simulator. Each patient was tested pre-SNRB, immediately post-SNRB, and 2 and 6 weeks post-SNRB. As controls 20 age- and sex-matched normal subjects were tested once. Full departmental, institutional, and ethical committee approval were obtained.

Results: Mean DRT of the control group was 452 milliseconds. Mean DRT of patients with right or left radiculopathy pre-SNRB was 521 milliseconds (P < 0.045) and 535 milliseconds (P < 0.018), respectively. In the right radiculopathic group, the measurements immediately post-SNRB, 2 weeks, and 6 weeks were 656 milliseconds (P < 0.005), 589 milliseconds (P < 0.019), and 564 milliseconds (P < 0.10), respectively. The delay immediately and at 2 weeks post-SNRB translates into an increase in stopping distance of 3.8 and 1.9 m, respectively at the speed of 100 km/h. In the left radiculopathic group, the measurements immediately post-SNRB, 2 weeks, and 6 weeks were 585 milliseconds (P < 0.037), 534 milliseconds, and 530 milliseconds, respectively. The delay immediately post-SNRB translates into an increase in stopping distance of 1.4 m at the speed of 100 km/h.

Conclusion: The study identified significant DRTs' changes both in radiculopathy and after SNRB. Right and left radiculopathic patients should be advised about the possible changes in their DRTs post-SNRB. Future research with regard to the suitability for radiculopathic patients to drive and the best time to resume driving post-SNRB is needed.