Relationship between the length of time off work preoperatively and clinical outcome at 24-month follow-up in patients undergoing total disc replacement or fusion

Abstract Background context A recent study involving interbody fusion patients found that preoperative work status was significantly related to clinical outcome. In another study comparing the best and worst outcomes of total disc replacement, among a battery of variables analyzed, the only one that...

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Bibliographic Details
Published in:The spine journal 2009-05, Vol.9 (5), p.360-365
Main Authors: Rohan, Michael X., DO, Ohnmeiss, Donna D., DrMed, Guyer, Richard D., MD, Zigler, Jack E., MD, Blumenthal, Scott L., MD, Hochschuler, Stephen H., MD, Sachs, Barton L., MD, Rashbaum, Ralph F., MD
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement - statistics & numerical data
Employment
Female
Fusion
Humans
Intervertebral Disc - pathology
Intervertebral Disc - surgery
Lumbar spine
Male
Orthopedics
Pain Measurement
Randomized Controlled Trials as Topic
Spinal Fusion - statistics & numerical data
Surgical outcome
Time
Time off work
Total disc replacement
Treatment Outcome
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Summary:Abstract Background context A recent study involving interbody fusion patients found that preoperative work status was significantly related to clinical outcome. In another study comparing the best and worst outcomes of total disc replacement, among a battery of variables analyzed, the only one that differentiated the best and worst outcome groups was the length of time off work before total disc replacement. Purpose The purpose of this study was to determine if there was a relationship between the length of time off work and treatment outcome at 24-month follow-up. If such a relationship existed, a secondary study objective would be to determine if a duration of work could be identified beyond which would be associated with compromised clinical outcome. Study design and setting Data were collected prospectively from randomized clinical trials comparing total disc replacement with lumbar fusion conducted at a single site. Patient sample A database of 232 patients enrolled in one of two Food and Drug Administration-regulated trials comparing total disc replacement with fusion for the treatment of symptomatic disc degeneration was the basis of the study group. Only patients who had reached 24-month follow-up were included. The 28 patients who were not employed by choice preoperatively were not included in the analysis. Outcome measures Primary outcome measures used were visual analog scales (VAS) assessing pain and Oswestry disability index. Methods The length of time off work before surgery was recorded in weeks. The mean percentage improvement between preoperative and 24-month follow-up scores were analyzed. Results There was a significant relationship between duration off work preoperatively and clinical outcome (p
ISSN:1529-9430
1878-1632
DOI:10.1016/j.spinee.2008.07.004