Hodges S D, Humphreys S C, Eck J C, Covington L A, Harrom H
Center for Sports Medicine and Orthopedics, Foundation for Research, in Chattanooga, Tenn., USA.
J Am Osteopath Assoc. 2001 Feb;101(2):78-83.
It is commonly believed that patients who are compensated for a work-related injury have less incentive to return to work. This study evaluated how various factors affected the outcomes of lumbar spine surgery in terms of pain relief, functional status, return to work, and general health. Eighty-seven workers' compensation patients had spinal fusion or microdiskectomy. Subjects were evaluated preoperatively and postoperatively using the Oswestry disability scale and the Visual Analog Scale for Pain. The type of surgery performed significantly affected patient outcomes, while such factors as gender, age, smoking, and litigation were insignificant. Microdiskectomy patients, for example, had greater reduction in pain and disability than did fusion patients (P < .01). Return-to-work status was negatively affected by fusion (P < .01). Overall, 55% of patients did return to work in some capacity, but the rate was 72% for microdiskectomy patients versus 43% for fusion patients. While outcomes significantly improved, postoperative scores remained severe. This did not correlate with return-to-work rates, suggesting that outcomes measures may not be effective.
人们普遍认为，因工伤获得赔偿的患者重返工作岗位的动力较小。本研究评估了各种因素如何在疼痛缓解、功能状态、重返工作岗位和总体健康方面影响腰椎手术的结果。八十七名工伤赔偿患者接受了脊柱融合术或显微椎间盘切除术。术前和术后使用奥斯维斯特残疾量表和视觉模拟疼痛量表对受试者进行评估。所进行的手术类型对患者的结果有显著影响，而性别、年龄、吸烟和诉讼等因素则无显著影响。例如，显微椎间盘切除术患者的疼痛和残疾程度比融合术患者有更大程度的减轻（P < 0.01）。融合术对重返工作岗位的状态有负面影响（P < 0.01）。总体而言，55%的患者确实以某种能力重返工作岗位，但显微椎间盘切除术患者的重返工作率为72%，而融合术患者为43%。虽然结果有显著改善，但术后评分仍然很高。这与重返工作率无关，表明结果测量可能无效。
