title: The Effect of Workers' Compensation Status on Outcomes of Cervical Disc Arthroplasty: A Prospective, Comparative, Observational Study.
abstract: BACKGROUND
  Receiving Workers' Compensation benefits has been associated with inferior outcomes after lumbar fusion. The purpose of our study was to compare the outcomes of cervical disc arthroplasty between patients receiving and those not receiving Workers' Compensation.
  
  
  METHODS
  Patient-reported outcomes, reoperations, complications, and return-to-work status were analyzed at one year after surgery in an observational cohort of consecutive patients who underwent single-level or multilevel cervical disc arthroplasty for symptomatic cervical disc conditions, including radiculopathy or discogenic pain with or without radiculopathy, exclusive of myelopathy.
  
  
  RESULTS
  Of the 189 patients who underwent cervical disc arthroplasty, 144 received Workers' Compensation and forty-five did not. The mean scores on all patient-reported measures improved significantly from preoperative baseline to one year after surgery (p < 0.001), and the improvement in patient-reported outcomes did not differ significantly between the Workers' Compensation and the non-Workers' Compensation group (respectively, 22.7 compared with 25.0 for the Neck Disability Index; 8.3 compared with 9.6 for the Short Form (SF)-36 physical component summary; 7.9 compared with 9.6 for the SF-36 mental component summary; 3.5 compared with 3.7 for neck pain; and 2.6 compared with 2.8 for arm pain). The two groups also did not differ significantly in the rate of reoperations (7.6% for those receiving Workers' Compensation compared with 13.3% for those not receiving Workers' Compensation) and complications (2.8% compared with 4.4%, respectively). At one year after surgery, the proportion of patients who had returned to work was comparable (77.7% in the Workers' Compensation group and 79.4% in the non-Workers' Compensation group); however, the patients receiving Workers' Compensation had significantly more days off before returning to work (a mean of 145.2 compared with 61.9 days; p = 0.001).
  
  
  CONCLUSIONS
  After cervical disc arthroplasty, patients receiving Workers' Compensation had outcomes that were similar to those of patients not receiving Workers' Compensation in terms of patient-reported outcomes, surgery-related complications, reoperations, and return-to-work status. Patients receiving Workers' Compensation remained off work for a longer interval than did patients not receiving Workers' Compensation.
  
  
  METHODS
  Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Spine Research Center, The Orthopedic Center of St. Louis, Chesterfield, Missouri.
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Gornet
authors.affiliation: SPIRITT Research, St. Louis, Missouri fschranck@spirittresearch.com.
authors.forename: Francine W
authors.initials: FW
authors.lastname: Schranck
authors.affiliation: SPIRITT Research, St. Louis, Missouri.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Copay
authors.affiliation: Department of Health Services, University of Washington, Seattle, Washington.
authors.forename: Branko
authors.initials: B
authors.lastname: Kopjar
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods; D002574:Cervical Vertebrae / Q000601:surgery*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D020127:Recovery of Function; D062707:Return to Work / Q000706:statistics & numerical data*; D018570:Risk Assessment; D057566:Self Report; D012720:Severity of Illness Index; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D014942:Workers' Compensation / Q000191:economics / Q000706:statistics & numerical data*