Factors Associated With Return to Work Following Laminoplasty for Degenerative Cervical Myelopathy.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY Clinical Spine Surgery Pub Date : 2024-11-04 DOI:10.1097/BSD.0000000000001713

Brian Q Hou, Andrew Croft, Hani Chanbour, Omar Zakieh, Alicia M Hymel, Jacquelyn S Pennings, Mason W Young, Mitchell F Bowers, Raymond J Gardocki, Julian G Lugo-Pico, Amir M Abtahi, Scott L Zuckerman, Byron F Stephens

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Abstract

Study design: Retrospective cohort study.

Objective: To identify factors predictive of returning to work within 90 days of laminoplasty for degenerative cervical myelopathy (DCM).

Background: DCM is a debilitating condition resulting from spinal canal stenosis and spinal cord compression. One surgical option for cord decompression is cervical laminoplasty. Factors influencing return to work (RTW) postsurgery are unknown.

Methods: This study included adult patients previously employed, undergoing primary elective laminoplasty for DCM, and with documented RTW status. Variables included demographic information, medical history, illness characteristics, and baseline patient-reported outcomes. The primary outcome of interest was RTW status at 90 days. Statistical analyses were conducted to identify predictors.

Results: Forty-six patients (67.6%) returned to work within 90 days, whereas 22 (32.3%) either RTW between 90 and 365 days (n = 3) or did not RTW within 365 days (n = 19). Significantly more patients who RTW within 90 days worked full-time (90.9% vs 64.3%, P = 0.030). Patients who RTW within 90 days had significantly lower preoperative Neck Disability Index scores (23.7 ± 17.5 vs 35.6 ± 14.3, P = 0.008) and higher preoperative modified Japanese Orthopedic Association scores (13.7 ± 2.5 vs 12.2 ± 2.7, P = 0.018) compared with those who did not RTW. No differences were found in other baseline patient-reported outcomes. Patients who RTW within 90 days had significantly lower postoperative 3-month neck pain (2.0 ± 2.1 vs 3.8 ± 2.6, P = 0.007), 3-month arm pain (1.3 ± 1.9 vs 3.6 ± 2.8, P < 0.001), 12-month neck pain (1.4 ± 1.6 vs 3.1 ± 2.4, P = 0.019) and 12-month arm pain (1.1 ± 1.8 vs 2.4 ± 2.4, P = 0.048) compared with those who did not RTW within 90 days. Higher preoperative modified Japanese Orthopedic Association scores were significantly associated with truncated time to RTW (HR: 1.14, 95% CI: 1.01-1.29, P = 0.034).

Conclusion: Patients with better preoperative neck and arm pain and functional scores were more likely to RTW within 90 days postlaminoplasty. Preoperative functional status plays an important role in assessing RTW postlaminoplasty. This information is valuable for preoperative patient counseling.

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退行性颈椎脊髓病椎板成形术后重返工作岗位的相关因素。

研究设计回顾性队列研究：目的：确定对退行性颈椎脊髓病（DCM）进行板层成形术后 90 天内重返工作岗位的预测因素：背景：退行性颈椎病是一种因椎管狭窄和脊髓受压而导致的衰弱性疾病。颈椎板成形术是脊髓减压的一种手术选择。影响术后重返工作岗位（RTW）的因素尚不清楚：本研究纳入了曾就业、因 DCM 而接受初级选择性颈椎板成形术且有 RTW 状态记录的成年患者。变量包括人口统计学信息、病史、疾病特征和患者报告的基线结果。主要研究结果是 90 天后的 RTW 状态。研究人员进行了统计分析，以确定预测因素：46名患者（67.6%）在90天内重返工作岗位，22名患者（32.3%）在90天和365天之间复工（3人）或在365天内未复工（19人）。在 90 天内完成复工的患者从事全职工作的比例明显更高（90.9% vs 64.3%，P = 0.030）。与未复工的患者相比，在90天内复工的患者术前颈部残疾指数评分明显较低（23.7 ± 17.5 vs 35.6 ± 14.3，P = 0.008），术前改良日本骨科协会评分较高（13.7 ± 2.5 vs 12.2 ± 2.7，P = 0.018）。患者报告的其他基线结果没有差异。90天内复工的患者术后3个月颈部疼痛（2.0 ± 2.1 vs 3.8 ± 2.6，P = 0.007）、3个月手臂疼痛（1.3 ± 1.9 vs 3.6 ± 2.8，P < 0.001）、12 个月颈部疼痛（1.4 ± 1.6 vs 3.1 ± 2.4，P = 0.019）和 12 个月手臂疼痛（1.1 ± 1.8 vs 2.4 ± 2.4，P = 0.048）。术前改良日本骨科协会评分越高，截肢时间越短（HR：1.14，95% CI：1.01-1.29，P = 0.034）：结论：术前颈部和手臂疼痛及功能评分较好的患者更有可能在板层成形术后 90 天内实现复工。术前功能状态对评估板层成形术后的复工起着重要作用。这些信息对术前患者咨询很有价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.