How to predict return to work after lumbar discectomy

Answers from the NeuroPoint-SD registry

Khoi Than, Jill N. Curran, Daniel K. Resnick, Christopher I. Shaffrey, Zoher Ghogawala, Praveen V. Mummaneni

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

OBJECTIVE: To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS: An observational prospective cohort study was completed at 13 academic and community sites (Neuro-Point-Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS: There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9% of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3% vs 28.6%, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5% vs 66.7%, p = 0.03), and those who were working preoperatively (91.8% vs 26.2%, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS: In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness.

Original languageEnglish (US)
Pages (from-to)181-186
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume25
Issue number2
DOIs
StatePublished - Aug 1 2016

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Diskectomy
Return to Work
Registries
Body Mass Index
Logistic Models
Smoking
Regression Analysis
Workers' Compensation
Cost-Benefit Analysis
Cohort Studies
Prospective Studies

Keywords

  • Lumbar discectomy
  • Prospective registry
  • Return to work

ASJC Scopus subject areas

  • Medicine(all)

Cite this

How to predict return to work after lumbar discectomy : Answers from the NeuroPoint-SD registry. / Than, Khoi; Curran, Jill N.; Resnick, Daniel K.; Shaffrey, Christopher I.; Ghogawala, Zoher; Mummaneni, Praveen V.

In: Journal of Neurosurgery: Spine, Vol. 25, No. 2, 01.08.2016, p. 181-186.

Research output: Contribution to journalArticle

Than, Khoi ; Curran, Jill N. ; Resnick, Daniel K. ; Shaffrey, Christopher I. ; Ghogawala, Zoher ; Mummaneni, Praveen V. / How to predict return to work after lumbar discectomy : Answers from the NeuroPoint-SD registry. In: Journal of Neurosurgery: Spine. 2016 ; Vol. 25, No. 2. pp. 181-186.
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abstract = "OBJECTIVE: To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS: An observational prospective cohort study was completed at 13 academic and community sites (Neuro-Point-Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS: There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9{\%} of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3{\%} vs 28.6{\%}, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5{\%} vs 66.7{\%}, p = 0.03), and those who were working preoperatively (91.8{\%} vs 26.2{\%}, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS: In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness.",
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AU - Ghogawala, Zoher

AU - Mummaneni, Praveen V.

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N2 - OBJECTIVE: To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS: An observational prospective cohort study was completed at 13 academic and community sites (Neuro-Point-Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS: There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9% of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3% vs 28.6%, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5% vs 66.7%, p = 0.03), and those who were working preoperatively (91.8% vs 26.2%, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS: In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness.

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