A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

Abstract

Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated. Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery. Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months. Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

Effectiveness of the Coordinated Return to Work model after orthopaedic surgery for lumbar discectomy and hip and knee arthroplasty: a register-based study

“…As the unit cost of one sickness absence day for the society is 420€ in Finland, the shortening effect has clear economic significance in reducing productivity losses. 24 RTW periods after all the three surgeries were mainly comparable to those from previous studies [16][17][18][19] for time before the CRtW model, and shorter after the model implementation.…”

“…17 Time to RTW after lumbar discectomy has varied in previous studies. In a small Korean study of 67 participants, the mean time of RTW after lumbar discectomy was 36 days, 18 while in a Danish study, the median time of RTW after lumbar discectomy was around 64-69 days. 19 In the Coordinated Return to Work (CRtW) model, 7 a collaboration of several public hospital care and private occupational health service providers was implemented to shorten the time of RTW.…”