Return to work within 2 years of lumbar fusion: a prospective cohort study.

Background and purpose:  Return to work is an important objective and measure of treatment success in the working-age population. Many patient-related factors have been shown to be associated with failure to resume working postoperatively. The aim of this longitudinal database study was to determine return to work rates in a 24-month follow-up after lumbar fusion. We also evaluated whether return to work was affected by the physical demand of work or the preoperative dominance of leg or back pain.

Methods:  348 consecutive patients available to the workforce underwent lumbar fusion. Return to work at 12 and 24 months was evaluated by patient questionnaires. Patients rated the physical demand of work into 3 categories: light, moderately demanding, or demanding. The surgeon identified the predominant symptom preoperatively, dividing patients into back and leg pain groups.

Results:  Return to work was 69% (95% confidence interval [CI] 64-73) and 76% (CI 71-81), at 12- and 24-month follow-ups, respectively. Patients in physically demanding work were less likely to resume working than patients in light work (63% vs 86% at 24 months, respectively). The predominant symptom did not affect return to work.

Conclusion:  In patients of working age, three-quarters of lumbar spine fusion patients returned to work within 2 years of surgery. Work absenteeism was higher in physically demanding occupations and only 60% of the patients with predominant leg pain returned to their physically heavy occupation in the first year following lumbar fusion.