Variables Affecting Return to Work After Spinal Surgery in a Non-workers’ Compensation Population: A Retrospective Cohort Study

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Introduction:Return-to-work (RTW) outcomes following spine surgery are critical information for patients aspiring to return to employment following surgical correction. Among patients receiving workers’ compensation (WC), spinal surgery has been repeatedly linked to poor RTW rates. However, among patients not receiving WC, the percentage of patients who return to employment is unclear.Methods:We conducted a retrospective cohort study of 326 non-WC patients who underwent spinal surgery at two institutions. We determined RTW status and analyzed potential predictors of RTW status.Results:Preoperative work status was the only markedly positive predictor of RTW status; patients who were working prior to their surgery were more likely to return to work after surgery. Patients with at least one comorbidity were less likely to return to employment. All other sociodemographic, surgery-related, and complication variables did not reach statistical significance. However, smoking status, short fusion, and cervical fusion were clinically relevant predictors of a negative RTW status.Discussion:Among non-WC patients, employment before surgery was a positive predictor for RTW status. For patients with a positive comorbidity status, a lower likelihood of returning to employment is predicted. Randomized trials are needed to fully explore the effect of predictor variables on RTW status among non-WC patients.Conclusions:Patients not receiving WC who underwent spinal surgery had a high chance of returning to employment within 1 year if they had been working at least 3 months before the date of surgery.

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