Rate of return to military active duty after single level lumbar interbody fusion:  a 5-year retrospective review.
BACKGROUND
Lumbar interbody fusion has been extensively studied in the civilian population; however, data regarding its efficacy in the military are lacking.


OBJECTIVE
To identify the rate of return to unrestricted active military duty after single-level lumbar interbody fusion surgery.


METHODS
The surgical database at a single tertiary care military treatment facility was queried for active-duty patients who underwent a single-level lumbar interbody fusion over a 5-year period. A retrospective chart review was performed with backward stepwise logistic regression analysis, and Fisher exact and Wilcoxon rank sum tests were used for statistical analysis.


RESULTS
A total of 102 patients met the inclusion criteria. Mean age at surgery was 34.0 years (range, 19-51 years). Most surgeries (59%) were performed for discogenic pain secondary to degenerative disc disease; the remaining patients underwent surgery for spondylolisthesis (39%) or spinal stenosis (2%). Thirty-nine patients (38%) were treated via an anterior approach (anterior lumbar interbody fusion), whereas 63 patients (62%) underwent fusion via a posterior approach (transforaminal or posterior lumbar interbody fusion). Fifty-six patients (55%) were able to return to unrestricted full active duty, and the remaining 46 patients (45%) were separated from the military. The return to active duty rate was significantly higher in older patients and those ranking E7 (Chief Petty Officer) and above (84.8%).


CONCLUSIONS
Fifty-five percent of the service members who underwent a single-level lumbar interbody fusion returned to unrestricted full duty. Older age and higher rank were statistically significant positive predictors of a successful return to active duty.
Department of Neurosurgery, Naval Medical Center San Diego, San Diego, California, USA. luis.tumialan@bnaneuro.net
Luis M
LM
Tumialán
Ryan P
RP
Ponton
Anthony I
AI
Riccio
Wayne M
WM
Gluf
D000328:Adult; D015897:Comorbidity; D004651:Employment / Q000706:statistics & numerical data*; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology / Q000517:prevention & control; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013122:Spinal Diseases / Q000453:epidemiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology