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Return to Work Following Novel Lumbar Total Joint Replacement.

Ashmal S Kabani1, Marissa Koscielski2, Jeff Goldstein3

  • 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience.

Clinical Spine Surgery
|December 11, 2025
PubMed
Summary

Lumbar total joint replacement (TJR) surgery facilitates return-to-work (RTW) for most patients within 3-6 months. Lower Oswestry disability index (ODI) scores post-surgery correlate with faster RTW, indicating improved functional outcomes.

Keywords:
Oswestry disability index (ODI)adjacent segment diseasechronic low back pain (CLBP)lumbar degenerative pathologieslumbar fusion surgerylumbar total joint replacement (TJR)motion preservationoccupational outcomespatient-reported outcomes (PROs)return-to-work (RTW)

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Area of Science:

  • Orthopedic Surgery
  • Spinal Surgery
  • Biomedical Engineering

Background:

  • Lumbar fusion surgery may lead to reoperation and functional limitations.
  • Lumbar total joint replacement (TJR) offers motion preservation for degenerative pathologies.
  • A cohort of 32 patients undergoing lumbar TJR between 2017-2020 was analyzed.

Purpose of the Study:

  • To evaluate return-to-work (RTW) outcomes after lumbar TJR.
  • To identify factors influencing time to RTW.
  • To assess the impact of Oswestry disability index (ODI) on RTW.

Main Methods:

  • Retrospective analysis of prospectively collected data.
  • Collected Oswestry disability index (ODI) at multiple postoperative timepoints.
  • Utilized ANOVA, generalized linear regression, and time-to-event analyses.

Main Results:

  • 100% of patients returned to work within 6 months; 96.9% by 3 months.
  • Lower ODI scores at 3 and 6 months correlated with shorter RTW times.
  • Kaplan-Meier analysis showed significant variations in RTW based on ODI.

Conclusions:

  • Lumbar TJR shows potential for timely RTW and improved function in degenerative lumbar conditions.
  • Preoperative functional status, indicated by ODI, is crucial for RTW.
  • Further multicenter studies are needed to confirm safety and efficacy.