Workers’ Compensation, Return to Work, and Lumbar Fusion for Spondylolisthesis
SOURCE: Orthopedics. 2016 (Jan); 39 (1): e1-8
Joshua T. Anderson, BS; Arnold R. Haas, BS, BA;
Rick Percy, PhD; Stephen T. Woods, MD;
Uri M. Ahn, MD; Nicholas U. Ahn, MD
Department of Orthopaedics (JTA, NUA),
University Hospitals Case Medical Center, Cleveland,
Case Western Reserve University School of Medicine (JTA),
Cleveland, and the Ohio Bureau of Workers’ Compensation (ARH, RP, STW),
Columbus, Ohio; and the
New Hampshire NeuroSpine Institute (UMA),
Bedford, New Hampshire
This is an interesting follow-up to a 2011 study drawn from the Ohio Bureau of Workers’ Compensation database.
In the 2011 study, two years AFTER surgery, only 26 percent had returned to work.
In this current study, researchers reviewed the files of 686 workers who underwent fusion surgery for spondylolisthesis between 1993 and 2013, revealing that only 29.9% of them ever returned to work (for at least 6 months). The failure rate (meaning return-to-work) was 70.1%.
Clearly, it’s time to consider more conservative approaches, like early referral for chiropractic care, long before they become chronic pain patients.
Lumbar fusion for spondylolisthesis is associated with consistent outcomes in the general population. However, workers’ compensation is a risk factor for worse outcomes. Few studies have evaluated prognostic factors within this clinically distinct population. The goal of this study was to identify prognostic factors for return to work among patients with workers’ compensation claims after fusion for spondylolisthesis. The authors used International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes to identify 686 subjects from the Ohio Bureau of Workers’ Compensation who underwent fusion for spondylolisthesis from 1993 to 2013.
Positive return to work status was recorded in patients who returned to work within 2 years of fusion and remained working for longer than 6 months. The criteria for return to work were met by 29.9% (n=205) of subjects. The authors used multivariate logistic regression analysis to identify prognostic factors for return to work.
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