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ANZ J Surg. 2012 Sep;82(9):625-9. doi: 10.1111/j.1445-2197.2012.06152.x. Epub 2012 Aug 7.

Spine surgery outcomes in a workers' compensation cohort.

Author information

1
South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia. ianharris@unsw.edu.au

Abstract

INTRODUCTION:

Lumbar spine surgery (fusion, disc replacement or decompression) is common, yet indications are unclear and outcomes, particularly in a workers' compensation setting, are not consistently favourable. This study aimed to determine the outcomes of spine surgery in an Australian workers' compensation cohort.

METHODS:

A retrospective review of prospectively collected data from WorkCover NSW and insurer agents was performed. Subjects were included if they had lumbar spine decompression, fusion or disc replacement procedures performed between 1 January 2004 and 31 December 2006 (inclusive). Main outcome measures were as follows: need for further lumbar spine surgery, return to work (RTW), return to pre-injury duties (PID) and need for ongoing physical treatment or prescription opioids. All outcomes were measured at 24 months post-surgery.

RESULTS:

A total of 476 patients had undergone lumbar spine surgery within the workers' compensation system. The revision surgery rate was 9.2%. The RTW rate and return to PID rate were 50.3% and 14.2%, respectively. The proportion of patients still undergoing treatment was 77.7%. The rates of RTW (or PID) and need for ongoing treatment were significantly worse in patients undergoing fusion and disc replacement, compared with patients undergoing decompressive procedures (laminectomy, discectomy).

DISCUSSION:

The findings do not support the use of lumbar spine fusion or disc replacement surgery as a method of achieving RTW and relief of pain in patients treated under workers' compensation.

[Indexed for MEDLINE]

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