May 06, 2015
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Gender, preoperative work status may predict return to work after lumbar discectomy

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WASHINGTON — Using a registry to better understand patients’ ability to return to work after single-level lumbar discectomy, researchers found patients who were working prior to surgery had the greatest chance of returning to work at 3 months postoperatively.

Khoi Duc Than, MD, presented findings from the study during the American Association of Neurological Surgeons Annual Meeting, here.

“We found the average time of work lost was 67 days, and we found that two-thirds of patients had returned to work 3 months after,” Than said.

The observational cohort study involved 148 patients who underwent lumbar discectomy between 2010 and 2011, with follow-up to 2012. The patients were included in the NeuroPoint-SD registry, which encompasses patients treated at 13 U.S. academic and community sites.

Ultimately, 127 patients were available to be analyzed at 3 months after surgery.

Than and colleagues assessed such variables as age, gender, BMI, preoperative SF-36 and Oswestry Disability Index (ODI) scores, preoperative working status, diabetes and smoking status, as well as whether patients had systemic diseases or workers compensation.

“Comparing patients who were working 3 months after surgery to those who were not, we found that younger age, male gender, lower SF-36 scores, lower ODI scores preoperatively, nonsmokers and patients working prior to surgery were most likely to return to work 3 months after,” Than said.

However, upon controlling for each of the variables in logistic regression, the researchers found men and patients working before surgery were the most likely to work at 3 months, according to Than.

Among the 89 patients who were working prior to lumbar discectomy, 88% resumed working at 3 months after surgery. For the patients not working prior to surgery, 18% were working at 3 months, according to Than.

“Looking only at patients working [preoperatively], the younger age was predictive of return to work after surgery, and this held true after logistic regression,” he said.

Than and colleagues found the average time off from work following surgery was 2 months.

“This was a surprise to all of us involved in the study, as we had been counselling patients they would be off 2 to 4 weeks,” he said.

Than was presented with the Stewart B. Dunsker, MD, Award for this research. – by Susan M. Rapp

Reference:

Than KD, et al. Paper #620. Presented at: American Association of Neurological Surgeons Annual Meeting. May 2-6, 2015; Washington, D.C.

Disclosure: Than reports no relevant financial disclosures.