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Study highlights link between fewer missed work days and lumbar discectomy
In a study that examined the effect of disc herniation surgery on workers’ earnings and missed workdays and studied the cost effectiveness of the procedure, Lane Koenig, PhD, and colleagues found surgery for lumbar disc herniation was cost-effective.
The investigators used data from the Spine Patient Outcomes Research Trial (SPORT) and other methods to compare the cost savings and results of lumbar discectomy and non-surgical treatment of disc herniation (DH).
“Disc herniation surgery is measured as more cost-effective when the benefits of surgery in terms of earnings and missed workdays are factored in and when the procedure is performed on an outpatient basis. The value of discectomy may be further enhanced by shifting more clinically appropriate patients to an outpatient setting,” Koenig and colleagues wrote in the study.
The data for patients who underwent DH surgery showed they missed an average of 3 fewer days or less from work annually compared to the patients who did not undergo the DH procedure.
“We estimate average annual earnings of $47,619 with surgery and $45,694 with non-surgical treatment. The increased earnings for patients receiving surgery as compared with non-surgical treatment is equal to $1,925 (95% CI; $1,121 to $2,728).” Koenig and colleagues wrote.
Surgical patients, on average, missed 7.6 days of work per year. By contrast, patients who underwent nonoperative care, on average, missed 10.6 days of work per year, based on the results the investigators reported.
To draw these conclusions, Koenig and colleagues examined the effect of surgery on workers’ productivity using clinical outcomes and utilities based on SPORT results (the pooled randomized and observation cohorts analyzed on an as-treated basis) and using the National Health Interview Survey to assess the effect of low back pain due to DH on earnings and missed time at work. They also looked at how these factors influenced the cost-effectiveness of surgical treatment for lumbar DH.
“Our study showed that functional limitations resulting from lumbar disc herniation were associated with lower earnings and an increased number of missed workdays. The level of improvement in functioning for patients undergoing disc herniation surgery suggests material offsets to the cost of surgery in terms of higher earnings and fewer missed workdays,” Koenig and colleagues wrote. – by Robert Linnehan
Disclosure: Koenig, Dall, Gu and Saavoss directly received research funding for this study from the American Academy of Orthopaedic Surgeons.
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Koenig L. Clin Orthop Relat Res. 2013. DOI: 10.1007/s11999-014-3486-0.