Return to Work After Surgery for Lumbar Disk Herniation: A Nationwide Registry-based Study

Area of Science:

• Orthopedics
• Neurosurgery
• Occupational Health

Background:

• Return to work (RTW) is a critical outcome following spine surgery.
• Understanding long-term RTW patterns after lumbar disk herniation surgery is essential.

Purpose of the Study:

• To investigate long-term sick leave patterns and postsurgery RTW achievement in patients undergoing lumbar disk herniation surgery.
• To analyze the influence of presurgery sick leave duration and surgical outcomes on sustainable RTW.

Main Methods:

• Observational registry-based study using Norwegian nationwide databases (NORspine and NAV).
• Included 13,698 patients (aged 18-60) undergoing lumbar disk herniation surgery (2007-2019).
• Survival analysis and logistic regression were used to assess RTW rates and the impact of surgical success (30% ODI improvement).

Main Results:

• 76% of patients achieved sustainable RTW within two years post-surgery.
• Shorter presurgery sick leave (<30 days) was strongly associated with higher RTW rates (99% achieved RTW).
• Extended presurgery sick leave (>180 days) reduced the positive impact of successful surgical outcomes on RTW.

Conclusions:

• The majority of patients return to work 2 years after lumbar disk herniation surgery.
• Presurgery sick leave duration is a key determinant of achieving faster and more sustainable RTW.
• While surgical success is beneficial, its impact on RTW diminishes with prolonged presurgery sick leave.