A new study published in the Journal of Neurosurgery: Spine examines the return-to-work rate after elective lumbar spine surgery for degenerative disc disease.
The study authors examined 4,694 patients who underwent elective spine surgery and followed the patients for three months. They used a multivariable Cox proportional hazards regression model that included several preoperative factors fitted for return-to-work and gauged the performance of their model with a concordance index. The study authors found:
1. Most patients — 82 percent — returned to work within three months of surgery.
2. Factors associated with lower likelihood of returning to work were:
• Employed preoperatively but not working at the time
• Manual labor jobs
• Workers compensation patients
• Liability insurance for disability
• High preoperative Oswestry Disability Index score
• High numeric rating scale score for back pain
3. There were demographic factors that decreased the likelihood of returning to work, including female sex, history of diabetes, high American Society of Anesthesiologists score and African American race.
4. Patients more likely to return to work often had at least graduated high school.
5. Study authors concluded their predictive model for the probability of returning to work could be used by spine care providers to educate patients and engage them in shared decision making for return to work outcomes. "This evidence-based decision support will result in better communication between patients and clinicians and improve postoperative recovery expectations, which will ultimately increase the likelihood of a positive RTW trajectory," they concluded.