Risk factors for back pain-related loss of working time after surgery for lumbar disc herniation: a 5-year follow-up study

Abstract

The aim of this study is to explore the occurrence and the risk factors of back-related loss of working time in patients undergoing surgery for lumbar disc herniation. One hundred and fifty-two gainfully employed patients underwent surgery for lumbar disc herniation. Two months postoperatively, those patients completed a selfreport questionnaire including queries on back and leg pain (VAS), functional capacity (Oswestry disability index-ODI, version 1.0), and motivation to work. After 5 years, lost working time was evaluated by means of a postal questionnaire about sick leave and disability pensions. The cumulative number of back pain-related days-off work was calculated for each patient. All 152 patients, 86 men and 66 women, were prescribed sick leave for the first 2 months. Thereafter, 80 (53%) of them reported back pain-related sick leave or early retirement. A permanent work disability pension due to back problems was awarded to 15 (10%) patients, 5 men (6%) and 10 women (15%). Median number of all work disability days per year was 11 (interquartile range [IQR] 9-37); it was 9 days (IQR 9-22) in patients with minimal disability (ODI score 0-20) at 2 months postoperatively and 67 days (IQR 9-352) in those with moderate or severe disability (ODI [ 20; P \ 0.001). The respective means were 61, 29, and 140 days/year. Multivariate analysis showed ODI [ 20, leg pain, and poor motivation to work to be the risk factors for extension of work disability. Results of the present study show that after the lumbar disc surgery, poor outcome in questionnaire measures the physical functioning (ODI) and leg pain at 2 months postoperatively, as well as poor motivation to work, are associated with the loss of working time. Patients with unfavourable prognosis should be directed to rehabilitation before the loss of employment.

What promotes sustained return to work of employees on long-term sick leave? Perspectives of vocational rehabilitation professionals

“…This study shows, in accordance with previous studies, that personal characteristics of the employee, such as having a positive attitude towards going back to work, and social support in the workplace (36,37) are promoting factors for RTW. Our findings are in line with a recent study that showed that positive working conditions, supportive workplace relationships, and work satisfaction are RTW facilitators following occupational injury (38).…”

Clinical outcomes of patients with lumbar disc herniation, selected for one-level open-discectomy and microdiscectomy

“…Since LDH disease became a sore point of the working population, there is a demand to set the risk factors for work disability days after concrete surgery, where the most predicting ODI [ 20, considerable degree of pain, poor motivation to work are among other confounding agents making the prognosis more complicated [44]. The early return to vigorous activities and daily work with the mean sick leave of 1.7 weeks seems likely not increasing the complication rate [8].…”

Proprioceptive use and sit-to-stand-to-sit after lumbar microdiscectomy: The effect of surgical approach and early physiotherapy

“…Indeed, lower ODI scores are associated with shorter work absence following lumbar disc herniation (Puolakka et al, 2008). For re-surgery, no related factors (age, gender, preoperative symptoms, physical activity, or employment) are previously defined; however, physiotherapy was not evaluated in that study (Häkkinen et al, 2007).…”