title: Reduced work capacity after lumbar disc surgery: the role of cognitive-behavioral and work-related risk factors.
abstract: A significant number of patients who have had surgery for lumbosacral radicular syndrome still have a reduced work capacity several months later. In a prospective cohort study of 182 people who underwent lumbar disc surgery, we determined the predictive value of preoperatively measured cognitive-behavioral and work-related factors on work capacity 6 months after surgery. Logistic regression analyses indicated that these factors independently predicted work capacity 6 months after surgery. Specifically, fear of movement/(re)injury, more passive pain coping, and higher physical work-load predicted reduced work capacity in multiple logistic regression analyses, taking into account the role of a wide range of control variables including demographic variables, preoperative disability and pain intensity, neurological deficits, intake of analgesics, duration of complaints, and pain intensity 3 days postoperatively. The study supports the need to develop and evaluate preoperative risk screening measures that include both cognitive-behavioral and work-related factors and to evaluate the effectiveness of cognitive-behavioral and work-related interventions in patients at risk of reduced work capacity after surgery for LRS.
authors.affiliation: Department of Physical Therapy, University Medical Centre Radboud, Nijmegen, The Netherlands. J.denBoer@fysio.umcn.nl
authors.forename: Jasper J
authors.initials: JJ
authors.lastname: den Boer
authors.forename: Rob A B
authors.initials: RA
authors.lastname: Oostendorp
authors.forename: Tjemme
authors.initials: T
authors.lastname: Beems
authors.forename: Marten
authors.initials: M
authors.lastname: Munneke
authors.forename: Andrea W M
authors.initials: AW
authors.lastname: Evers
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001416:Back Pain / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D003071:Cognition; D015331:Cohort Studies; D004185:Disability Evaluation; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014938:Work Capacity Evaluation; D016526:Workload