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Return to Work After Diskogenic Fusion in Workers' Compensation Subjects
Orthopedics
|December 15, 2015
Summary
Lumbar fusion for degenerative disk disease (DDD) in workers' compensation patients has poor return-to-work rates. Preoperative factors like prolonged time off work and psychiatric history significantly predict poor outcomes.
Area of Science:
- Orthopedic Surgery
- Occupational Health
- Health Services Research
Background:
- Degenerative disk disease (DDD) treated with lumbar fusion shows variable outcomes.
- Patients with workers' compensation claims often experience poorer fusion results.
- Limited research exists on risk factors for poor outcomes in this specific population.
Purpose of the Study:
- Identify preoperative predictors of return to work after lumbar fusion for DDD.
- Focus on patients within a workers' compensation system.
Main Methods:
- Retrospective cohort study using Ohio Bureau of Workers' Compensation data (1993-2013).
- Identified 1037 patients who underwent lumbar fusion for DDD.
- Multivariate logistic regression analysis to determine predictors of return to work.
Main Results:
- Only 23.2% of patients sustained a return to work within 2 years.
- Key predictors of not returning to work included prolonged time off work, psychiatric history, and opioid analgesic use.
- Patients not returning to work experienced worse outcomes, including failed back syndrome and additional surgeries.
Conclusions:
- Lumbar fusion may have a limited role for DDD patients with workers' compensation claims.
- Further research is needed to assess fusion's impact on function and quality of life in this group.
- Identifying preoperative risk factors is crucial for managing patient expectations and outcomes.
