Return to Work After Lumbar Microdiskectomy: A Systematic Review and Meta-analysis

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Rehabilitation Medicine

Background:

• Lumbar microdiskectomy is a common procedure for degenerative disc herniation.
• Evidence regarding the postoperative return to work (RTW) prevalence and timeline is limited.
• Understanding RTW trends is crucial for patient management and rehabilitation planning.

Purpose of the Study:

• To systematically review and meta-analyze the existing evidence on the prevalence and timeline of return to work (RTW) after lumbar microdiskectomy.
• To identify factors influencing RTW after this surgical procedure.

Main Methods:

• Systematic review and meta-analysis of studies identified through extensive database searches (Medline, Embase, Cinahl, Scopus, Web of Science).
• Quality assessment of included studies using the Quality in Prognosis Studies (QUIPS) tool.
• Random effects meta-analysis and meta-regression were employed to synthesize data.

Main Results:

• A total of 31 studies were included in the meta-analysis.
• The mean prevalence of postoperative return to work was 78% (95% CI 71%-83%).
• The mean time to return to work was 4.79 weeks (95% CI 3.88-5.70 weeks).
• Meta-regression indicated a significant but small effect of follow-up duration on RTW prevalence.
• Considerable heterogeneity was observed across the included studies.

Conclusions:

• Approximately 70% to 80% of patients return to work within 1.5 months following lumbar microdiskectomy for disc herniation.
• Return to work beyond this period appears unlikely.
• Preoperative symptom duration did not significantly affect the prevalence of return to work.
• These findings should inform surgical planning and postoperative rehabilitation goal setting.