Work Status Before Surgery Strongest Predictor of Return to Work After Lumbar Discectomy

Preoperative working status was the strongest predictor of postoperative working status three months after lumbar disectomy, according to Khoi Duc Than, MD – winner of the Stewart B. Dunsker, MD, award – who presented his research, How to Predict Return to Work After Lumbar Discectomy: Answers from the NeuroPoint SD Registry, recently.

To date, the factors that predict whether a patient returns to work after lumbar discectomy are unknown. Gathering information on postoperative work status is important in analyzing a procedure’s cost effectiveness.

Researchers completed an observational prospective cohort study at 13 academic and community sites (NeuroPoint-SD registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, gender, BMI, SF-36 physical function score, ODI, diabetes, smoking status, systemic illness, workers compensation status and preoperative work status. The primary outcome was working status within three months after surgery. Logistic regression analysis was performed to determine which factors were predictive of return to work at three months following discectomy.

Data collected from 127 patients (out of 148 total) at three months postoperatively revealed that the average age was 46 +/- 1 years and 66.9 percent of patients were working at three months postoperatively. Statistical analysis demonstrated that those more likely to return to work were patients of younger age, males, those with higher SF-36 physical function scores, those with lower ODI, non-smokers and those who were working preoperatively. Logistic regression analysis found that gender and preoperative work status were the most important factors. When controlling for those who were working preoperatively (89 patients), only age was a statistically significant predictor of postoperative return to work.

Factors not influencing return to work in the logistic regression analysis included gender, BMI, SF-36 physical function score, ODI, diabetes, smoking status and systemic illness.

There was not enough information regarding workers compensation status to draw conclusions regarding that variable.

Source: American Association of Neurological Surgeons