Failed lumbar disc surgery and repeat surgery following industrial injuries.

Waddell, Gordon; Kummel, Ed; Lotto, W. N.; Graham, John D.; Hall, Hamilton; McCulloch, John A.

doi:10.2106/00004623-197961020-00007

Cited by 267 publications

(120 citation statements)

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“…Although we have no objective data to support this, these differences may be partly explained by the fact that, for instance, patients with radicular symptomology within the lumbar and cervical disease groupsdue to the intensity of their symptoms-and patients candidate for arthroplasty-due to their prioritization in waiting lists-may have not had time to go through this adaptation period. On the other hand, patients with lumbalgia, as we have seen, are more often awaiting legal actions associated with their job situation; this may have a greater effect on their mental functioning, irrespective of the chronicity of the process [5,9,22,33,47,52]. The health questionnaire was given on the day before surgery, once the patient had been admitted to the hospital.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

et al. 2012

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Introduction Despite the high prevalence of musculoskeletal diseases, in Spain there are few data about how these conditions affect the quality of life of individuals. The objective of this study was to assess the quality of life (QOL) of patients candidate for orthopedic surgical treatment using an age-gender adjusted method of QOL scores. Materials and methods The SF-36 Health Survey was administered to 538 patients candidate for surgery between surgical treatment was classified in four groups (lumbar disease, cervical disease, knee arthroplasty, and hip arthroplasty). Associated morbidities were collected retrospectively for all cases using the Charlson co-morbidity index. Univariate, bivariate, and multivariate statistical analyses were done to compare the four groups to each other, to the general population mean, and to the age and gender-adjusted population mean. Results 234 men and 304 women whose mean age was 58.78 years (19-89) were assessed. Patients candidate for some kind or lumbar surgery had the worst scores in all physical and mental scales as compared to the other disease groups. Patients candidate for knee arthroplasty, had the best quality of life scores in all scales, compared to the other disease groups. Medical conditions had no influence over the summary measures. Conclusion Presenting the results of SF-36 in standard deviations from the age-and gender-adjusted population mean (T values) leads to a better appreciation of the differences between the various diseases. Patients candidate for surgery of the lumbar spine had a worse QOL, while the QOL in patients candidate for knee arthroplasty was the least affected.

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Section: Discussionmentioning

confidence: 99%

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

et al. 2012

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“…In a study of 103 patients, Waddell et al reported the success rate of a second operation to be 50%, while 20% of patients considered themselves worse off afterwards [20]. Furthermore, the number of surgical successes diminishes proportionally to the number of procedures performed [4,20].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, we were not able to predict the need for psychosocial support from the preoperative DPQ score. The relation between chronic pain symptoms and psychosocial status has been discussed and shown to be important [3,10,20]. Using psychological tests, Waddell et al found that 65% of patients with multiple back operations showed evidence of anxiety, depression, hypochondriasis and conversion reactions [20].…”

Section: Discussionmentioning

confidence: 99%

“…It is generally believed that apart from situations where obvious measurable instability exists, a repeat surgical procedure such as spinal fusion does not improve functional outcome in more than an average of 50% of cases (range 25%-80%) [11,12,17,20]. It appears that the reason for failure is most often neither technical nor physiological, but rather is attributable to a need for improved indication.…”

Section: Introductionmentioning

confidence: 99%

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Functional outcome after posterolateral spinal fusion using pedicle screws: comparison between primary and salvage procedure

Christensen

Thomsen

Eiskjær

et al. 1998

European Spine Journal

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Lumbar spinal fusion is a commonly performed surgical procedure, yet both the indications for its performance and its results remain controversial. It is generally believed that apart from situations where obvious measurable instability exists, a repeat surgical procedure such as spinal fusion does not improve the functional outcome in more than an average of 50% of cases. The aim of this study was to analyse functional outcome after posterolateral lumbar or lumbosacral spinal fusion, comparing primary and salvage procedures. It was designed as a prospective case/referent study with a 2-year follow-up. A total of 39 patients underwent a short posterior fusion with Cotrel-Dubousset (CD) pedicle screw fixation after earlier surgery of the lumbar spine. Two patients were erroneously omitted from the study at the index, so 37 patients were included in the salvage group. In the same period, 69 patients underwent lumbar fusion with pedicle screw fixation (CD) as primary surgery (referent group). Functional outcome was assessed by means of the Dallas Pain Questionnaire preoperatively and 1 and 2 years postoperatively. Fusion rates were determined by ordinary X-ray evaluation by two independent observers. Patients who had undergone previous spinal surgery had a significant improvement in functional outcome in terms of daily activity, work and leisure-time activities and anxiety/depression. With regard to social functioning, a significantly inferior outcome was found after the salvage procedure. The return-to-work rates at 2 years after surgery were 50% in the salvage group and 53% in the referent group. There was a significant correlation between radiological evaluation of the fusion mass and the functional outcome. The fusion rate was 76% in the salvage group and 72% in the referent group. This study demonstrates that a posterolateral spinal fusion can be effectively used as a salvage procedure. The functional and radiological outcome of the patients with revision surgery did not differ from those of the group of patients who underwent primary surgery. There was, however a clear indication of inferior social functioning after revision surgery.

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“…While the vast majority of injured workers recover and resume productivity, a small but significant percentage of these patients remain disabled in a chronic state Mayer et al, 2003). Significantly, the disability compensation system has been identified as being associated with barriers to recovery among patients, relative to patients not receiving disability compensation (Flynn & Hoque, 1979;Sander & Meyers, 1986;Waddell et al, 1979). Reviews of State Workers' Compensation databases have indicated that as little as 7% of these chronically disabled patients account for about approximately 70% of the annual costs to the Workers' Compensation system Hashemi, Webster, Clancy, & Volinn, 1997;Hashemi, Webster, Clancy, & Courtney, 1998).…”

Section: Introductionmentioning

confidence: 99%

Cost-Effectiveness of Early Versus Delayed Functional Restoration for Chronic Disabling Occupational Musculoskeletal Disorders

2014

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Failed lumbar disc surgery and repeat surgery following industrial injuries.

Cited by 267 publications

References 0 publications

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

Evaluation of health-related quality of life in patients candidate for spine and other musculoskeletal surgery

Functional outcome after posterolateral spinal fusion using pedicle screws: comparison between primary and salvage procedure

Cost-Effectiveness of Early Versus Delayed Functional Restoration for Chronic Disabling Occupational Musculoskeletal Disorders

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