Long-Term Care Plan Improves Return-To-Work Rates For Back Surgery Recipients On Workers" Comp
While spinal fusion comes with risks for anyone, including the risks of failure and reoperation, they tend to be higher in patients with workers' compensation insurance.
Lumbar fusions in this population have been found to have return-to-work rates as low as one-quarter to one-third of recipients, while reoperation is needed in about a quarter of recipients.
How can these outcomes be improved? A group of researchers sought to test the effectiveness of a functional restoration program after lumbar surgeries in patients with workers' compensation.
Three-hundred thirty-one patients received spinal fusion, 233 received a different spinal surgery and 349 received no surgery, serving as a comparison group.
Patients in the surgery groups underwent the functional restoration program, which included a progressive exercise program, between one and one-and-a-half years after their initial surgeries.
Researchers measured rates of depression, perceived disability and opioid dependence post-surgery and pre-rehabilitation program.
They then measured return-to-work, opioid dependency, disability, depression and length of disability post-rehabilitation.
Opioid dependence post-surgery was found to correspond significantly to lower return-to-work rates.
Patients in the lumbar fusion group had higher opioid dependency scores than those in the other groups.
Depression and pain intensity scores were different between the groups, but the scores evened out after the rehabilitation program.
Depression and perceived disability were established as risk factors for poor return-to-work rates.
Length of disability was longest in those who received fusion (31.
6 months), lowest in those who received a different form of surgery (21.
7 months) and in between for those who weren't operated on (25.
9 months).
A major finding was that, after undergoing the rehabilitation program, all groups had very similar return-to-work rates, ranging from 81-85%.
This study suggests that a long-term rehabilitation program for people receiving back surgery that addresses psychological factors like depression and disability perception, as well as other important factors like opioid dependency and exercise, can increase the likelihood that patients return to work.
Patients and the medical professionals treating them should understand that the success or failure of a surgery depends on more than the procedure itself.
A patient's mental and emotional states, as well as his or her activity levels, all play a significant role in the ability to live a normal life after surgery.
Multimodal treatment plans, incorporating psychological measures, exercise therapy and close attention to drug intake can help back pain patients return to work after treatment.
See more on the study at http://www.
ncbi.
nlm.
nih.
gov/pubmed/24231782?dopt=Abstract.
Lumbar fusions in this population have been found to have return-to-work rates as low as one-quarter to one-third of recipients, while reoperation is needed in about a quarter of recipients.
How can these outcomes be improved? A group of researchers sought to test the effectiveness of a functional restoration program after lumbar surgeries in patients with workers' compensation.
Three-hundred thirty-one patients received spinal fusion, 233 received a different spinal surgery and 349 received no surgery, serving as a comparison group.
Patients in the surgery groups underwent the functional restoration program, which included a progressive exercise program, between one and one-and-a-half years after their initial surgeries.
Researchers measured rates of depression, perceived disability and opioid dependence post-surgery and pre-rehabilitation program.
They then measured return-to-work, opioid dependency, disability, depression and length of disability post-rehabilitation.
Opioid dependence post-surgery was found to correspond significantly to lower return-to-work rates.
Patients in the lumbar fusion group had higher opioid dependency scores than those in the other groups.
Depression and pain intensity scores were different between the groups, but the scores evened out after the rehabilitation program.
Depression and perceived disability were established as risk factors for poor return-to-work rates.
Length of disability was longest in those who received fusion (31.
6 months), lowest in those who received a different form of surgery (21.
7 months) and in between for those who weren't operated on (25.
9 months).
A major finding was that, after undergoing the rehabilitation program, all groups had very similar return-to-work rates, ranging from 81-85%.
This study suggests that a long-term rehabilitation program for people receiving back surgery that addresses psychological factors like depression and disability perception, as well as other important factors like opioid dependency and exercise, can increase the likelihood that patients return to work.
Patients and the medical professionals treating them should understand that the success or failure of a surgery depends on more than the procedure itself.
A patient's mental and emotional states, as well as his or her activity levels, all play a significant role in the ability to live a normal life after surgery.
Multimodal treatment plans, incorporating psychological measures, exercise therapy and close attention to drug intake can help back pain patients return to work after treatment.
See more on the study at http://www.
ncbi.
nlm.
nih.
gov/pubmed/24231782?dopt=Abstract.