Using Work Status as an Outcome Measure After Back SurgeryIs there any real way to predict the outcome of lumbar spine fusion? More than 2000 studies have been published on the topic of predicting disability after low back injury. Factors identified so far include physical health; use of drugs, alcohol, or tobacco; and job satisfaction. Other variables include family support and Workers' Comp status.
Work status at the time of surgery is the focus of this study. Can work status predict the final outcome of lumbar fusion? Anterior lumbar interbody fusion (ALIF) with titanium cages was the treatment for 106 patients with disc problems.
Three-fourths of the group had a single-level fusion. The rest had two levels fused at the same time. One patient had a three-level fusion. Pain, levels of function and activity, and work status were measured before and after surgery. Everyone was followed for at least one year. Many patients were re-evaluated periodically for two years or more.
The authors report that patients who were working at the time of surgery were 10 times more likely to go back to work after surgery. This was compared with patients who weren't working at all. Pain levels were improved for the workers after surgery. Their function didn't change significantly.
About 90 per cent of the patients who were working before surgery went back to work. Only about 43 per cent of the nonworkers returned to a work setting or job of some kind.
The results of this study agree with other studies that suggest patients with chronic low back pain needing surgery should work right up until the surgery is done. This is true even if the job has to be modified. Lighter duties or fewer hours may be necessary on a temporary basis.
Paul A. Anderson, MD, et al. Work Status as a Predictor of Surgical Outcome of Discogenic Low Back Pain. In Spine. October 1, 2006. Vol. 31. No. 21. Pp. 2510-2515.
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