A new article published in Spine examines the return-to-work rate for patients who undergo single-level cervical fusions for radiculopathy and compared their results with patients who underwent fusion for degenerative disc disease.
The study authors collected retrospective data for 21,169 patients who filed work-related injury claims with the Ohio Bureau of Workers’ Compensation from 1993 to 2011. The patients had cervical comorbidities. The researchers found:
1. The factors affecting successful return-to-work after surgery include:
• Degenerative disc disease diagnosis
• Age older than 50 years
• Out of work for more than six months
• Psychological evaluation
• Opioid use
• Legal litigation
• Permanent disability
2. The patients in the degenerative disc disease group reported lower return to work success and were less likely to sustain return-to-work status. The DDD group reported 50.9 percent return-to-work compared with 62.9 percent in the radiculopathy group.
3. One year after surgery, the return to work rate was 39.9 percent in the DDD group compared with 53.1 percent in the radiculopathy group.
4. On average, patients in the DDD group reported 112 more absent days than the radiculopathy patient group.
5. The researchers recommended physicians only recommend surgery after conservative measures failed and a radiographic abnormality at the symptomatic level is present in patients with mechanical back or neck pain without radicular symptoms.
“The decision to include surgical intervention in the management plan of cervical DDD should be approached with caution as the surgical outcome might not necessarily lead to improved postsurgical functionality and achieve sustained early RTW,” concluded the study authors.