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Time to return to work after elective lumbar spine surgery.
Supriya Singh1, Tamir Ailon1, Greg McIntosh2
11Combined Neurosurgical and Orthopedic Spine Service, Department of Orthopedic Surgery, University of British Columbia, Vancouver, British Columbia.
Journal of Neurosurgery. Spine
|September 24, 2021
Summary
Most patients (71%) return to work after lumbar spine surgery within a median of 61 days. Preoperative work status significantly impacts return to work timelines, with those working prior to surgery having a higher likelihood of early return.
Area of Science:
- Neurosurgery
- Orthopedics
- Occupational Health
Background:
- Return to work (RTW) after elective lumbar spine surgery is highly variable.
- Factors influencing RTW include patient characteristics, work-related issues, and surgical details.
Purpose of the Study:
- To describe the time and rate of RTW after elective lumbar spine surgery.
- To identify predictors of early RTW (< 90 days) and no RTW in this patient population.
Main Methods:
- Retrospective analysis of prospectively collected data from the Canadian Spine Outcomes and Research Network (CSORN) registry.
- Inclusion of employed patients undergoing 1- or 2-level discectomy, laminectomy, and/or fusion between 2015-2019.
- Multivariable Cox and logistic regression models used to determine predictors of early RTW and no RTW, respectively.
Main Results:
- 71% of 1805 employed patients returned to work at a median of 61 days.
- Median RTW: 51 days (discectomy), 46 days (laminectomy), 90 days (fusion).
- Predictors of early RTW: male gender, higher education, higher PCS, preoperative work, nonfusion procedure, western Canadian province. Predictors of no RTW: longer symptoms, more comorbidities, lower education, active workers' compensation claim, not working preoperatively.
Conclusions:
- 71% of preoperatively employed patients returned to work after 1- or 2-level lumbar spine surgery in Canada.
- Nonfusion procedures typically result in RTW within 6-8 weeks, while fusion procedures take around 12 weeks.
- Preoperative work status is a significant predictor of early RTW.
