Workers' Compensation Status and Outcomes Following Lumbar Surgery

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Health Services Research

Background:

• Lumbar decompression surgery is a common procedure for spinal conditions.
• Patient-reported outcome measures (PROMs) are crucial for evaluating surgical success.
• Preoperative workers' compensation (WC) status may influence surgical outcomes.

Purpose of the Study:

• To investigate the impact of preoperative workers' compensation (WC) status on PROMs after lumbar decompression with or without fusion.
• To compare outcomes between patients with WC, without WC (NWC), and retired patients.

Main Methods:

• Retrospective review of 571 patients undergoing lumbar decompression (2013-2017).
• Patients categorized into NWC, WC, or retired groups.
• Statistical analysis included paired t tests, Kruskal-Wallis H test, and multiple linear regression to assess WC status as a predictor of outcome changes.

Main Results:

• WC patients demonstrated significant postoperative improvement in pain and function but less improvement compared to NWC or retired patients.
• WC status was an independent predictor of decreased improvement in physical function and pain.
• WC patients not returning to work showed significantly poorer outcomes in back and leg pain.

Conclusions:

• Workers' compensation status is associated with diminished improvement in patient-reported outcomes following lumbar decompression surgery.
• Returning to work may mitigate the negative impact of WC status on pain and functional recovery.