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Findings cite preop predictors of return to work after lumbar fusion in workers' comp patients
Investigators of this study found several patient factors, such as the presence of a pre-existing psychiatric disorder and prolonged opioid use, which were strong negative predictors of return to work in workers’ compensation patients who underwent lumbar fusion surgery for degenerative disc disease.
Researchers evaluated 1,037 patients from the Ohio Bureau of Workers’ Compensation database who underwent anterior, posterior or 360° lumbar fusion for degenerative disc disease and discogenic low back pain with at least 3-years follow-up. Of these patients, 23.2% returned to work within 2 years of their procedures.
The researchers used multivariate logistic regression analysis to determine several preoperative predictors of return to work. Compared with the out of work group, subjects in the return to work group had an 8% lower rate of being male, a 40.7% lower rate of being out of work for longer than 1 year before the procedure and an 11.5% lower rate for both psychiatric disorders and having legal representation. In addition, subjects in the return to work group were 1.8 years younger, were out of work for 421.7 fewer days and were supplied with opioids for 296.2 fewer days.
Researchers concluded the poor return to work rates and other poor outcomes may suggest a more limited role of spinal fusion procedures for subjects with DDD and discogenic low back pain who are receiving workers’ compensation. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.