Romagna Alexander, Wilson Jefferson R, Jacobs W Bradley, Johnson Michael G, Bailey Christopher S, Christie Sean, Paquet Jerome, Nataraj Andrew, Cadotte David W, Manson Neil, Hall Hamilton, Thomas Kenneth C, Schwartz Christoph, Rampersaud Y Raja, McIntosh Greg, Fisher Charles G, Dea Nicolas
University of Toronto, Toronto, Ontario, Canada.
Paracelsus Private Medical University, Salzburg, Austria.
Global Spine J. 2022 May;12(4):573-578. doi: 10.1177/2192568220958669. Epub 2020 Oct 16.
Retrosepctive analysis of prospectively collected data from the multicentre Canadian Surgical Spine Registry (CSORN).
Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in North America. Few studies have evaluated return to work (RTW) rates after DCM surgery. Our goals were to determine rates and factors associated with postoperative RTW in surgically managed patients with DCM.
Data was derived from the prospective, multicenter Canadian Spine Outcomes and Research Network (CSORN). From this cohort, we included all nonretired patients with at least 1-year follow-up. The RTW rate was defined as the proportion of patients with active employment at 1 year from the time of surgery. Unadjusted and adjusted analyses were used to identify patient characteristics, disease, and treatment variables associated with RTW.
Of 213 surgically treated DCM patients, 126 met eligibility, with 49% working and 51% not working in the immediate period before surgery; 102 had 12-month follow-up data. In both the unadjusted and the adjusted analyses working preoperatively and an anterior approach were associated with a higher postoperative RTW ( < .05), there were no significant differences between the postoperative employment groups with respect to age, gender, preoperative mJOA (modified Japanese Orthopaedic Association) score, and duration of symptoms ( > .05). Active preoperative employment (odds ratio = 15.4, 95% confidence interval = 4.5, 52.4) and anterior surgical procedures (odds ratio = 4.7, 95% confidence interval = 1.2, 19.6) were associated with greater odds of RTW at 1 year.
The majority of nonretired patients undergoing surgery for DCM had returned to work 12 months after surgery; active preoperative employment and anterior surgical approach were associated with RTW in this analysis.
对前瞻性收集的来自多中心加拿大脊柱外科登记处（CSORN）的数据进行回顾性分析。
退行性颈椎脊髓病（DCM）是北美脊髓功能障碍最常见的原因。很少有研究评估DCM手术后的重返工作岗位（RTW）率。我们的目标是确定接受手术治疗的DCM患者术后RTW的发生率及相关因素。
数据来源于前瞻性、多中心的加拿大脊柱结局与研究网络（CSORN）。从该队列中，我们纳入了所有至少随访1年的非退休患者。RTW率定义为从手术时间起1年时仍在积极工作的患者比例。采用未调整和调整分析来确定与RTW相关的患者特征、疾病和治疗变量。
在213例接受手术治疗的DCM患者中，126例符合条件，术前近期49%的患者在工作，51%的患者未工作；102例有12个月的随访数据。在未调整和调整分析中，术前工作和前路手术与术后较高的RTW相关（P<0.05），术后就业组在年龄、性别、术前改良日本骨科协会（mJOA）评分和症状持续时间方面无显著差异（P>0.05）。术前积极工作（优势比=15.4，95%置信区间=4.5，52.4）和前路手术（优势比=4.7，95%置信区间=1.2，19.6）与1年时更高的RTW几率相关。
大多数接受DCM手术的非退休患者在术后12个月已重返工作岗位；在本分析中，术前积极工作和前路手术方法与RTW相关。
