Return-to-work after interlaminar endoscopic sequestrectomy: case series

Considering the epidemiology of single-level lumbar disc herniations (LDH) in the young and active patients, the impact on working capacity is highly relevant. The timing of return-to-work after lumbar surgery through various modalities differs greatly. This may be partly due diverse disparate surgical approaches along with differences in patient and surgeon. The purpose of this paper is to provide evidence for a return-to-work policy after endoscopic sequestrectomy and discuss possible clues to a faster recovery of patients that did not receive a sick-leave report via a case series. The sample comprises fourteen cases of single-level LDH that underwent endoscopic interlaminar sequestrectomy and did not receive a sick-leave report and were advised to return-to-work whenever they felt fit so. Time until return-to-work, pre- and post-operative leg VAS pain scores and amount of analgesic used post-operatively were retrospectively analyzed. Fourteen patients were operated on using the same technique and on average returned to work after 6.6 ± 1.8 days, used 3.7 ± 2.5 analgesic tablets before returning to work and had a postoperative leg VAS pain score of 1.4 ± 1.2. No patient requested a sick-leave report during the follow-up period of 1 month. The patients in this case series had a remarkably short period of sick-leave and a low number of analgesic usage. These findings may be due to selection of patients who were operated on specifically for leg pain with the absence of lower back pain suggesting integrity of annulus fibrosus. We can postulate that intraoperative preservation of lamina, facet joint and annulus fibrosus along with reassurance of the surgeon suggesting to return-to-work whenever fell fit so were the key factors in the swifter recovery of the patients.