1 Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
2 Department of Social and Preventive Medicine, Medical University of Vienna, Austria.
Scand J Public Health. 2019 May;47(3):281-292. doi: 10.1177/1403494818785055. Epub 2018 Jul 5.
Scientific knowledge about risk factors for work disability in terms of long-term sickness absence and disability pension following lumbar spine decompression surgery remains insufficient. This study aimed to investigate the associations between socio-demographic, work-related, and medical characteristics with subsequent long-term sickness absence (>90 days) and disability pension for individuals who underwent lumbar spine decompression surgery.
A prospective cohort study of all individuals aged 19-60 years with diagnosed dorsopathies, who underwent lumbar spine decompression surgery 2008-10 in Sweden ( n=7373) was performed. Univariate and multivariate hazard ratios with 95% confidence intervals regarding long-term sickness absence and disability pension with a 3-year follow-up period were estimated by Cox proportional regression.
Low educational level, being a non-European immigrant and preoperative sickness absence were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.8). Female sex was a risk factor for long-term sickness absence (hazard ratios: 1.3) whereas age >44 years and being a Nordic immigrant were risk factors for disability pension (hazard ratios: 1.9-2.6). Medical factors as common mental disorders, other mental disorders, prescribed psychiatric medication and somatic comorbidity were risk factors for both long-term sickness absence and disability pension (hazard ratios: 1.2-3.4). A simultaneous lumbar fusion surgery and high preoperative pain severity were risk factors for long-term sickness absence (hazard ratios 1.2-1.8).
To prevent long-term work disability after lumbar spine decompression surgery, specific focus is required on older and female patients, those with mental or somatic comorbidities, high levels of preoperative pain or sickness absence, with a simultaneous lumbar fusion surgery, a low educational level or a non-European immigrant background.
关于腰椎减压手术后长期病假和残疾抚恤金的工作残疾风险因素的科学知识仍然不足。本研究旨在调查社会人口统计学、与工作相关和医疗特征与随后的长期病假（>90 天）和残疾抚恤金之间的关联，这些个体接受了腰椎减压手术。
对 2008-10 年在瑞典接受腰椎减压手术的诊断为背病的 19-60 岁所有个体进行了一项前瞻性队列研究（n=7373）。通过 Cox 比例风险回归估计了 3 年随访期间长期病假和残疾抚恤金的单变量和多变量危险比及其 95%置信区间。
低教育水平、非欧洲移民和术前病假是长期病假和残疾抚恤金的危险因素（危险比：1.2-3.8）。女性是长期病假的危险因素（危险比：1.3），而年龄>44 岁和北欧移民是残疾抚恤金的危险因素（危险比：1.9-2.6）。常见精神障碍、其他精神障碍、规定的精神药物治疗和躯体合并症等医疗因素是长期病假和残疾抚恤金的危险因素（危险比：1.2-3.4）。同时进行腰椎融合手术和术前疼痛严重程度高是长期病假的危险因素（危险比 1.2-1.8）。
为了预防腰椎减压手术后的长期工作残疾，需要特别关注老年和女性患者、患有精神或躯体合并症、术前疼痛或病假程度高、同时进行腰椎融合手术、教育水平低或非欧洲移民背景的患者。
