Return to Work After Surgery for Lumbar Disk Herniation: A Nationwide Registry-based Study.

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY Spine Pub Date : 2025-02-15 Epub Date: 2024-06-28 DOI:10.1097/BRS.0000000000005082
Sozaburo Hara, Lene Aasdahl, Øyvind Salvesen, Tore Solberg, Sasha Gulati, Karen W Hara
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Abstract

Study design: An observational registry-based study.

Objective: We investigated the long-term patterns of sick leave among patients undergoing surgery for lumbar disk herniation using two nationwide databases to study the achievement of postsurgery return to work (RTW).

Summary of background data: The ability to RTW is increasingly recognized as an essential outcome measure for spine surgery.

Materials and methods: The study included 13,698 patients aged 18 to 60 on sick leave undergoing surgery for lumbar disk herniation from January 2007 through January 2019. Data from the Norwegian Registry for Spine Surgery (NORspine) and the Norwegian Labour and Welfare Administration (NAV) were linked. Certified sick leave around the time of surgery was assessed. The patients were further categorized according to the length of presurgery sick leave, and the rate of sustainable RTW for the different groups was compared using survival analysis. The association between successful surgical outcomes, defined by a 30% improvement in Oswestry Disability Index score, and achievement of sustainable RTW was analyzed using a logistic regression model.

Results: Two years after surgery, 76% of the patients had returned to work. Shorter presurgery sick leave was associated with a higher proportion and rate of achieved sustainable RTW: Among patients with sick leave of <30 days, a total of 99% achieved sustainable RTW (median: 46 days); only 40% of patients with longer lasting work assessment allowance achieved the same goal within 2 years. Successful surgical outcomes were associated with sustainable RTW for all patient groups, but the impact of surgical success on RTW declined as sick leave extended beyond 180 days.

Conclusions: Most patients had returned to work 2 years after lumbar disk herniation surgery. Shorter presurgery sick leave was associated with achieving faster and more sustainable RTW. Successful surgical outcomes had less impact on patients with extended sick leave.

Level of evidence: Level III.

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腰椎间盘突出症手术后重返工作岗位:一项基于全国登记的研究。
研究设计基于登记的观察性研究:我们利用两个全国性数据库调查了腰椎间盘突出症手术患者的长期病假模式,以研究手术后重返工作岗位(RTW)的实现情况:背景数据摘要:人们日益认识到,重返工作岗位的能力是衡量脊柱手术效果的重要指标:研究纳入了2007年1月至2019年1月期间接受腰椎间盘突出症手术的13698名18至60岁病假患者。研究将挪威脊柱外科登记处(NORspine)和挪威劳动与福利局(NAV)的数据联系起来。对手术前后的认证病假进行了评估。根据手术前病假的长短对患者进行进一步分类,并使用生存分析法对不同组别的可持续复工率进行比较。使用逻辑回归模型分析了成功的手术结果(Oswestry残疾指数评分改善30%)与可持续复工率之间的关系:结果:手术两年后,76%的患者重返工作岗位。手术前病假较短的患者实现可持续复工的比例和比率较高:在病假少于 30 天的患者中,共有 99% 的患者实现了可持续复工(中位数为 46 天);而在工作评估津贴持续时间较长的患者中,只有 40% 的患者在两年内实现了同样的目标。在所有患者组别中,成功的手术结果都与可持续的复工有关,但随着病假超过180天,手术成功对复工的影响就会下降:结论:大多数患者在腰椎间盘突出症手术两年后重返工作岗位。结论:大多数患者在腰椎间盘突出症手术后两年就能重返工作岗位。手术前病假越短,重返工作岗位的速度越快,持续时间越长。成功的手术结果对延长病假的患者影响较小:证据等级:III。
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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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