SpineLate postoperative results in 1000 work related lumbar spine conditions
Section snippets
Patient population
This study is based on a neuro-orthopedic examination of 1000 operated workers. Mailed follow-up questionnaires or telephone interviews were never used. To assure impartiality, none of the 1000 patients was evaluated by the treating surgeon. Under existing Workers Compensation Board regulations, a final examination to assess permanent partial incapacity and functional limitations may be required by the Board. This examination is usually carried out by a Board-appointed neurosurgeon or
Discussion
Review of the literature revealed that conventional lumbar discectomies showed a better outcome than fusion based on return to work rates within a year [18]. Low back pain persisting for more than half a year constitutes a watershed since little improvement can be expected even after several surgical procedures [60]. In one series 67.7% of patients described the backache as being worse after the operation, and 55.8% stated that quality of life had suffered [31]. Anterior fusion results were
Conclusion
Postoperative results in lumbar spine surgery in a Worker’s Compensation group remain disappointingly poor and are similar to findings in other reported series. There exists an astonishing discrepancy between the paucity of neurological deficits and the failure to reintegrate into the work force. The main problem appears to be chronic pain, according to the patients. Among various pain generating factors, periradicular fibrosis is mentioned with increasing frequency in the medical literature.
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