Predictors of Return to Work After Lumbar Discectomy: Insights from a Comprehensive Study and Comparative Analysis

Abstract

This retrospective study delves into the multifaceted realm of lumbar disc herniation (LDH) and its impact on patients' ability to return to work (RTW) post-surgery. LDH, a common source of pain and disability, predominantly affects individuals in their working years, making RTW a pivotal indicator of surgical effectiveness. Analyzing data from 106 patients who underwent single-level LDH surgery between 2019 and 2023, this study explored various factors influencing RTW. Results were multifaceted, revealing significant improvements in postoperative pain levels, validating the efficacy of surgical interventions. Nevertheless, no statistically significant differences in RTW were observed based on gender, LDH level, or occupation, although a trend toward longer RTW times for female patients and lower self-efficacy scores for manual workers emerged. However, this study introduced an additional dimension by assessing the influence of occupational status, highlighting potential disparities among occupational groups in self-efficacy beliefs related to RTW. The utilization of the Return-to-Work Self-efficacy Questionnaire (RTWE-SE-19) provided insights into patients' confidence levels regarding their ability to return to work. Generally, patients exhibited moderate to high self-efficacy scores, reflecting their positive beliefs in RTW capabilities. In essence, this study contributes to the growing body of knowledge surrounding LDH and RTW by emphasizing the multifactorial nature of this issue. It underscores the significance of surgical pain relief and the need for further investigation into the nuanced influences of gender, occupation, and psychological factors on postoperative RTW. Ultimately, these insights pave the way for tailored interventions and improved RTW outcomes for LDH surgery patients

Keywords

• Lumbar Disc Herniation
• Return to Work
• Surgical Outcomes
• Self-Efficacy Occupational Status

References

1. Atarod, M., Mirzamohammadi, E., Ghandehari, H., Mehrdad, R., & Izadi, N. (2021). Predictive factors for return to work after lumbar discectomy. International Journal of Occupational Safety and Ergonomics: JOSE, 27(2), 517–522. https://doi.org/10.1080/10803548.2019.1600890
2. Frank, J. W., Kerr, M. S., Brooker, A. S., DeMaio, S. E., Maetzel, A., Shannon, H. S., Sullivan, T. J., Norman, R. W., & Wells, R. P. (1996). Disability resulting from occupational low back pain. Part I: What do we know about primary prevention? A review of the scientific evidence on prevention before disability begins. Spine, 21(24), 2908–2917. https://doi.org/10.1097/00007632-199612150-00024
3. Gadjradj, P. S., Arts, M. P., van Tulder, M. W., Rietdijk, W. J. R., Peul, W. C., & Harhangi, B. S. (2017). Management of Symptomatic Lumbar Disk Herniation: An International Perspective. Spine, 42(23), 1826–1834. https://doi.org/10.1097/BRS.0000000000002294
4. Horn, L., Spronken, M., Brouwers, E. P. M., de Reuver, R. S. M., & Joosen, M. C. W. (2022). Identifying Return to Work Self-Efficacy Trajectories in Employees with Mental Health Problems. Journal of Occupational Rehabilitation, 32(1), 64–76. https://doi.org/10.1007/s10926-021-09979-2
5. Johansson, A.-C., Öhrvik, J., & Söderlund, A. (2016). Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery. European Spine Journal: Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 25(1), 296–303. https://doi.org/10.1007/s00586-015-3820-6
6. Khan, I., Bydon, M., Archer, K. R., Sivaganesan, A., Asher, A. M., Alvi, M. A., Kerezoudis, P., Knightly, J. J., Foley, K. T., Bisson, E. F., Shaffrey, C., Asher, A. L., Spengler, D. M., & Devin, C. J. (2019). Impact of occupational characteristics on return to work for employed patients after elective lumbar spine surgery. The Spine Journal: Official Journal of the North American Spine Society, 19(12), 1969–1976. https://doi.org/10.1016/j.spinee.2019.08.007
7. Laasik, R., Lankinen, P., Kivimäki, M., Neva, M. H., Aalto, V., Oksanen, T., Vahtera, J., & Mäkelä, K. T. (2021). Return to work after lumbar disc herniation surgery: An occupational cohort study. Acta Orthopaedica, 92(6), 638–643. https://doi.org/10.1080/17453674.2021.1951010
8. Paulsen, R. T., Rasmussen, J., Carreon, L. Y., & Andersen, M. Ø. (2020). Return to work after surgery for lumbar disc herniation, secondary analyses from a randomized controlled trial comparing supervised rehabilitation versus home exercises. The Spine Journal: Official Journal of the North American Spine Society, 20(1), 41–47. https://doi.org/10.1016/j.spinee.2019.09.019

9. Schade, V., Semmer, N., Main, C. J., Hora, J., & Boos, N. (1999). The impact of clinical, morphological, psychosocial and work-related factors on the outcome of lumbar discectomy. Pain, 80(1–2), 239–249. https://doi.org/10.1016/s0304-3959(98)00210-3
10. Than, K. D., Curran, J. N., Resnick, D. K., Shaffrey, C. I., Ghogawala, Z., & Mummaneni, P. V. (2016). How to predict return to work after lumbar discectomy: Answers from the NeuroPoint-SD registry. Journal of Neurosurgery. Spine, 25(2), 181–186. https://doi.org/10.3171/2015.10.SPINE15455.