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Return to work after surgery for lumbar disc herniation. A rehabilitation-oriented approach in insurance medicine
P Donceel1, M Du Bois, D Lahaye
1Department of Occupational and Insurance Medicine, School of Public Health, Katholieke Universiteit Leuven, Belgium. peter.donceel@med.kuleuven.ac.be
Study Design:
An intervention study by the medical advisers of a social security sickness fund on a mandatorily insured patient population after open discectomy for herniated lumbar intervertebral disc. The medical advisers were randomized into two groups: a control group (n = 30) and an intervention group (n = 30).
Objectives:
To compare a rehabilitation-oriented approach in insurance medicine focused primarily on early mobilization and early resumption of professional activities with the usual claim-based practice.
Summary Of Background Data:
This study included 710 patients, with a mean age of 39.2 years, who underwent surgery for herniated lumbar disc.
Methods:
Medical advisers in the rehabilitation-oriented group examined the patients monthly, starting at 6 weeks after the surgical intervention. They used a newly developed protocol to motivate the patients and treating physicians toward social and professional reintegration.
Results:
At 52 weeks, 10.1% of the patients guided by medical advisers from the rehabilitation-oriented group had not resumed work in contrast to 18.1% of the patients in the control group. It was statistically proven that this effect also holds during the follow-up period.
Conclusions:
A rehabilitation-oriented approach by the medical advisers of social security can increase the probability of a return to work for patients after lumbar disc herniation surgery.
