The Influence of No Fault Compensation on Functional Outcomes After Lumbar Spine Fusion

Abstract

2.

Does Workers’ Compensation Status Affect Outcomes after Lumbar Spine Surgery? A Systematic Review and Meta-Analysis

“…Out of these studies, 27 were excluded (no lumbar surgery, n = 3; no surgical intervention, n = 3; not defined WC group, n = 5; sample population including non-operative treatment, n = 1; unclear outcomes, n = 5 and results not estimable, n = 10). After this process, 26 articles were included in our study [ 16 , 18 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ].…”

“…Pain evaluation in these studies was performed using NRS (3 studies [ 26 , 27 , 32 ]) and VAS (5 studies [ 16 , 25 , 38 , 39 , 41 ]) scores. The disability outcome was evaluated by one or more of the following scales: ODI (7 studies [ 16 , 18 , 25 , 27 , 28 , 40 , 41 ]); SF-36 (2 studies [ 16 , 27 ]); SF-12 (1 study [ 40 ]); RMDQ (1 study [ 36 ]); FS (2 studies [ 24 , 45 ]) and LBOS (3 studies [ 36 , 39 , 42 ]). RTW was evaluated in 9 studies [ 25 , 26 , 28 , 29 , 33 , 41 , 43 , 44 , 46 ] and satisfaction rate in 15 studies [ 23 , 25 , 26 , 29 , 30 , 31 , 33 , 34 , 35 , 37 , 39 , 43 , 44 , 45 , 46 ].…”

“…The studies cited in this review show a moderate heterogeneity between groups (50% < I 2 < 70%, except for the ODI subgroup with a I 2 = 71%) and differences in terms of study design, interventions, and outcome variables. Follow-ups were different and ranged from 6 months [ 38 ] to 16 years [ 36 ].…”

“…The ROBINS-I tool for NRCT was used to assess the methodological quality of each study. We found 7 studies with an overall risk of bias identified as “low” [ 18 , 25 , 29 , 30 , 34 , 35 , 40 ], 14 studies with a “moderate” risk [ 16 , 24 , 26 , 27 , 28 , 31 , 32 , 33 , 38 , 41 , 42 , 43 , 45 , 46 ] and 5 studies with a “serious” risk [ 23 , 36 , 37 , 39 , 44 ]. The quality of evidence of the studies included in the GRADE was classified as “low”.…”

“…Moderate heterogeneity in the length of follow-up and the surgical procedure were reported in all the studies. We included all types of lumbar spine surgery: discectomy [ 25 , 26 , 31 , 32 , 33 , 34 , 35 , 45 ], laminectomy [ 31 , 45 ], hemilaminotomy [ 34 ], lumbar spine fusion [ 36 ], minimally invasive surgery or open approach for transforaminal lumbar interbody fusion (TLIF) [ 16 , 28 , 38 , 41 ], posterior lumbar interbody fusion (PLIF) [ 18 , 23 ], posterior lumbar fusion (PLF) [ 18 , 23 , 27 , 30 , 37 , 43 ], anterior lumbar interbody fusion (ALIF) [ 29 , 39 , 40 , 44 ], anteroposterior fusion [ 24 ] and uninstrumented posterolateral fusion [ 46 ]. The authors divided the description of intervention per outcome (LBP, disability, satisfaction rate and RTW).…”