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Updated: Oct 30, 2025

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Does Workers' Compensation Status Affect Outcomes after Lumbar Spine Surgery? A Systematic Review and Meta-Analysis.

Fabrizio Russo1, Sergio De Salvatore1, Luca Ambrosio1

  • 1Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, 00128 Rome, Italy.

International Journal of Environmental Research and Public Health
|July 2, 2021
PubMed
Summary

Receiving workers' compensation (WC) negatively impacts outcomes for patients undergoing lumbar spine surgery. These patients report increased pain, disability, and lower satisfaction, with a delayed return to work.

Keywords:
disabilityinsurancelow back painlumbar decompressionlumbar fusionmusculoskeletal disordersoccupational healthpainreturn to worksatisfaction

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Area of Science:

  • Orthopedics
  • Neurosurgery
  • Pain Management
  • Health Services Research

Background:

  • Low back pain (LBP) is a leading cause of global disability and a common reason for workers' compensation (WC) claims.
  • WC receipt is linked to poorer prognoses across various health conditions, but its effect on lumbar spine surgery outcomes remains debated.

Purpose of the Study:

  • To systematically review and analyze the impact of workers' compensation status on patient outcomes following lumbar spine surgery.

Main Methods:

  • A comprehensive meta-analysis was conducted using data from Medline, Scopus, CINAHL, EMBASE, and CENTRAL databases.
  • Included studies focused on patients undergoing lumbar spine surgery with reported compensation status.
  • Methodological quality and evidence quality were assessed using ROBINS-I and GRADE ratings, respectively.

Main Results:

  • The analysis encompassed 26 studies involving 2668 patients.
  • Workers' compensation patients experienced higher post-operative pain and disability compared to non-WC patients.
  • Workers' compensation patients reported lower satisfaction and a delayed return to work post-surgery.

Conclusions:

  • Compensation status is significantly associated with adverse outcomes after lumbar spine surgery.
  • Understanding the clinical and work-related factors influencing post-operative outcomes is crucial for a holistic approach to patient recovery.