Factors Associated with 12-month Return to Work Following One-level Posterior Lumbar Fusion for Grade 1 Degenerative Spondylolisthesis: An Analysis of the Quality Outcomes Database. (1st September 2019)

• Record Type: Journal Article
• Authors: Bydon, Mohamad; Mummaneni, Praveen V; Kerezoudis, Panagiotis; Chan, Andrew Kai-Hong; Glassman, Steven D; Foley, Kevin T; Slotkin, Jonathan R; Potts, Eric A; Shaffrey, Mark E; Shaffrey, Christopher I; Coric, Domagoj; Knightly, John J; Park, Paul; Fu, Kai-Ming G; Devin, Clinton J; Asher, Anthony L; Bisson, Erica F
• Is Part Of: Neurosurgery. Volume 66(2010)Supplement 1
• Publication Date: 2019-09-01
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyz310_624
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Return to work (RTW) has become an increasingly important metric of spinal surgery success. Lumbar spondylolisthesis is a relatively common spinal pathology that may manifest as low back pain and/or leg pain, causing functional disability and hindering patients from working and performing activities of daily living. Currently, there is a lack of nationwide data evaluating RTW in lumbar spondylolisthesis. METHODS: We queried the Quality Outcomes Database for employed patients that underwent single-level posterior spinal fusion for Meyerding grade I degenerative lumbar spondylolisthesis. We compared cases who returned to work within 12 mo with regard to baseline demographics, comorbidities, clinical characteristics, and patient reported outcomes. A multivariable logistic regression model was fitted for 12-mo RTW adjusting for an array of pre- and intraoperative variables. RESULTS: A total of 163 patients with available 12-mo follow-up data (84%) were analyzed. Median age was 57 yr (interquartile range: 51-60 yr) and 57% were females (n = 93). On multivariable analysis, patients that were working at the time of surgery were significantly more likely to RTW compared to those that were not working (OR 4.62, 95% CI 1.42-15.07, P < .001). In addition, college education (OR 3.30, 95% CI 1.18-9.24, P = .02) was associated with significantly higher odds of returning to work compared to high-school or less education. The effect of postcollege education (OR 5.27, 95% CI 1.46-19.05, P = .01), baseline ODI score (OR 0.64, 95% CI 0.34 - 1.21, P = .17) and smoking status (OR 0.45, 95% CI 0.13-1.54, P = .20) were not found to be significant. Model c-statistic was 0.76. CONCLUSION: Analysis of data from a national spinal registry revealed that employment status at the time of surgery and education level were the most significant predictors of 12-moh RTW for patients undergoing single-level posterior lumbar fusion for degenerative spondylolisthesis. The findings of the present study may assist surgeons and patients with setting realistic treatment expectations during preoperative discussions.