Abstract
Abstract
INTRODUCTION
Low back pain is a leading cause of work-related disability in the United States and results in significant costs, including up to $20 billion annually due to lost productivity of the gainfully employed. Thus, return to work (RTW) is an important metric in the comparison of fusion versus decompression alone for grade 1 degenerative lumbar spondylolisthesis (DLS).
METHODS
This was a retrospective analysis of a prospective registry. A total of 599 patients underwent surgery for grade 1 DLS at 12 high-enrolling sites. Baseline variables were collected. Employment was defined as being employed and actively working or employed and on leave at time of surgery. RTW was assessed at 3 and 12 mo following surgery.
RESULTS
At baseline, 264 patients (44.1%) were employed. At baseline, there were a higher proportion of patients in the fusion cohort (219/462; 47.4%) who were employed compared with the decompression alone cohort (45/137; 32.8%; P = .003). At 3 and 12 mo, for patients eligible for RTW, 62.6% and 74.3%, respectively, were able to do so. In a subgroup analysis of the decompression alone cohort, 64.1% demonstrated RTW at 3 mo with a rate that was similar at 12 mo (65.0%) (P = .94). In the fusion cohort, 62.3% demonstrated RTW at 3 mo with rates that continued to increase at 12 mo (75.8%) (P = .01). There were no significant differences in RTW between the decompression alone and fusion cohorts at 3 and 12 mo (P = .83 and P = .30, respectively).
CONCLUSION
At 12 mo, the overall RTW rate was equivalent between the decompression and fusion cohorts. The decompression alone cohort reached peak RTW at 3 mo, which remained stable at 12 mo. Though the fusion cohort showed similar RTW at 3 mo, the proportion continued to rise at 12 mo. Further study is required to determine RTW rates in longer follow-up.
