Predicting factors of successful recovery from lumbar spine surgery among workers' compensation patients.
It is commonly believed that patients who are compensated for a work-related injury have less incentive to return to work. This study evaluated how various factors affected the outcomes of lumbar spine surgery in terms of pain relief, functional status, return to work, and general health. Eighty-seven workers' compensation patients had spinal fusion or microdiskectomy. Subjects were evaluated preoperatively and postoperatively using the Oswestry disability scale and the Visual Analog Scale for Pain. The type of surgery performed significantly affected patient outcomes, while such factors as gender, age, smoking, and litigation were insignificant. Microdiskectomy patients, for example, had greater reduction in pain and disability than did fusion patients (P < .01). Return-to-work status was negatively affected by fusion (P < .01). Overall, 55% of patients did return to work in some capacity, but the rate was 72% for microdiskectomy patients versus 43% for fusion patients. While outcomes significantly improved, postoperative scores remained severe. This did not correlate with return-to-work rates, suggesting that outcomes measures may not be effective.
Hodges
S D
SD
Center for Sports Medicine and Orthopedics, Foundation for Research, in Chattanooga, Tenn., USA.
Humphreys
S C
SC
Eck
J C
JC
Covington
L A
LA
Harrom
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000601:surgery*; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology / Q000601:surgery*; D010147:Pain Measurement / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology*; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000379:methods; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014942:Workers' Compensation / Q000706:statistics & numerical data*