Outcomes and presurgery correlates of lumbar discectomy in Utah Workers' Compensation patients.
BACKGROUND
Lumbar discectomy is the most common type of back surgery performed in the United States. Outcomes after this procedure can be variable and it appears that Workers' Compensation patients might be at increased risk for poor outcomes.


OBJECTIVE
To examine long-term multidimensional outcomes of lumbar discectomy within a cohort of Workers' Compensation patients from Utah and identify presurgical biopsychosocial factors related to poor outcomes.


METHODS
A retrospective cohort study consisting of a review of presurgical medical records and assessment of patient outcomes via a telephone survey. Outcomes were assessed at least 2 years postsurgery.


METHODS
A consecutive sample of 271 workers from Utah who underwent lumbar discectomy from 1994 to 1999. A total of 134 patients were surveyed at the time of follow-up.


METHODS
Patient satisfaction, Roland-Morris Disability Questionnaire, SF-36v2, and Stauffer-Coventry Index.


METHODS
A retrospective review of presurgical biopsychosocial variables and outcome assessment via telephone survey was conducted.


RESULTS
Work disability rate for the cohort was 12.7% (17/134). Analysis of patient satisfaction, back pain-related dysfunction, and the Short-Form Health Survey-36 subscales indicated approximately 25% of patients experienced poor outcomes. Older age, number of comorbid health conditions, assigned case manager, litigation, and time delay from injury to surgery were consistently statistically significant predictors (p<.05) of poor outcomes.


CONCLUSIONS
Results of this study suggest that compensated back surgery patients are at greater risk for poor lumbar discectomy outcomes than noncompensation patients. Presurgery correlates of poor outcomes may be useful in identifying high-risk compensation patients.
DeBerard
M Scott
MS
Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, Utah 84322-2810, USA. scott.deberard@usu.edu
LaCaille
Rick A
RA
Spielmans
Glen
G
Colledge
Alan
A
Parlin
Mary Ann
MA
D000328:Adult; D000367:Age Factors; D015897:Comorbidity; D004185:Disability Evaluation; D017586:Diskectomy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011584:Psychology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014589:Utah; D014942:Workers' Compensation