Improvements in Return to Work Following Lumbar Discectomy With a Bone-Anchored Annular Closure Device

Lumbar discectomy is the most frequently performed spinal surgery, and timely return to work is an important marker of functional recovery. Patients with large annular defects are at increased risk of reherniation and reoperation. Bone-anchored annular closure devices have been shown to reduce reherniation rates, but their effect on return to work has not been reported. This study investigates whether treatment with a bone-anchored annular closure device enables faster return to work in high-risk lumbar discectomy patients with large annular defects.

In this prospective, multicenter, single-arm post-market study, 55 patients with large annular defects undergoing limited lumbar discectomy received a bone-anchored annular closure device. Employment status and return to work were assessed at 4 weeks, 3 months, and 12 months via questionnaires. Preoperative predictors of delayed return to work were analyzed using univariate logistic regression. Patients who were students, retirees, or stay-at-home parents were excluded from return-to-work analyses. Adverse events, reherniation, and reoperation were recorded.

Among 46 employed patients (mean age, 41 years; 40% women), mean return to work was 3.4 weeks; 93% resumed work by 3 months and of those, 61% returned within 4 weeks and 100% by 9 weeks. Smoking was associated with delayed return to work (5.9 vs 3.2 weeks; P = 0.014). Two patients (3.6%) experienced symptomatic reherniation, 1 of whom required reoperation. No device-related adverse events were observed.

Treatment with a bone-anchored annular closure device enabled rapid return to work in high-risk lumbar discectomy patients while maintaining low rates of reherniation and reoperation.

These findings support the use of bone-anchored annular closure as an adjunct to lumbar discectomy in patients with large annular defects to accelerate return to work.