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A Prospective Observational Study of Return to Work after Single Level Lumbar Discectomy

Journal of Korean Neurosurgical Society 2020년 63권 6호 p.806 ~ 813
강숙형, 양진서, 조성원, 전진평, 최혁재,
소속 상세정보
강숙형 ( Kang Suk-Hyung ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
양진서 ( Yang Jin-Seo ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
조성원 ( Cho Sung-Won ) - Barrow Neurological Institute
전진평 ( Jeon Jin-Pyeong ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery
최혁재 ( Choi Hyuk-Jai ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Neurosurgery

Abstract


Objective : Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated.

Methods : Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery.

Results : Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months.

Conclusion : RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.

키워드

Lumbar; Diskectomy; Return to work; Loss of work capability; Patient reported outcome measures

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