Kang Suk-Hyung, Yang Jin Seo, Cho Steve Sungwon, Cho Yong-Jun, Jeon Jin Pyeong, Choi Hyuk Jai
Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Hallym University College of Medicine, Chuncheon, Korea.
The Barrow Neurological Institute, Phoenix, AZ, USA.
J Korean Neurosurg Soc. 2020 Nov;63(6):806-813. doi: 10.3340/jkns.2020.0227. Epub 2020 Nov 1.
Lumbar disc herniation (LDH) is a common disease, and lumbar discectomy (LD) is a common neurosurgical procedure. However, there is little previous data on return to work (RTW) after LD. This study investigated the period until the RTW after LD prospectively. Clinically, the pain state at the time of RTW also checked. RTW failure rate 6 months after surgery also investigated.
Patients with daily/regular jobs undergoing LD between September 2014 and December 2018 were enrolled. Pain was assessed by the Oswestri Disability Index (ODI) and the Numeric Rate Scale (NRS). Employment type was divided into self-employed, regular and contracted. Monthly telephone interviews were conducted to check RTW status and self-estimated work capability after surgery.
Sixty-seven patients enrolled in this study. Three patients failed to RTW, and three others resigned within 6 months after surgery. The preoperative NRS and ODI were 7.2±1.2 and 22.1±7.9, respectively. The average time to RTW was 5.1±6.0 weeks. At RTW, NRS was 1.5±1.8 and ODI was 6.3±3.9. Amongst patients that successfully returned to work were 16 self-employed workers, 42 regular employees, and three contracted workers. The time to RTW of self-employed, regular, and contracted workers were 5.9±8.8, 4.2±4.3 and 13.3±2.3 weeks, respectively (p=0.011). Thirty-six of the patients that returned to work self-reported a 22.8±15.6% reduction in work capability at 6 months.
RTW may vary depending on the employment status. In this study, we found that while employment type may affect the length to RTW, most patients were able to RTW and >40% of patients reported no loss of work capabilities 6 months postoperatively, hopefully alleviating some patient hesitation towards LD.
腰椎间盘突出症（LDH）是一种常见疾病，腰椎间盘切除术（LD）是一种常见的神经外科手术。然而，此前关于LD术后重返工作岗位（RTW）的数据很少。本研究前瞻性地调查了LD术后至RTW的时间。临床上，还检查了RTW时的疼痛状态。还调查了术后6个月的RTW失败率。
纳入2014年9月至2018年12月期间接受LD手术的日常/固定工作患者。采用奥斯威斯残疾指数（ODI）和数字评分量表（NRS）评估疼痛。就业类型分为个体经营、固定员工和合同制。每月进行电话访谈，以检查RTW状态和术后自我估计的工作能力。
本研究共纳入67例患者。3例患者未能RTW，另有3例在术后6个月内辞职。术前NRS和ODI分别为7.2±1.2和22.1±7.9。平均RTW时间为5.1±6.0周。RTW时，NRS为1.5±1.8，ODI为6.3±3.9。成功重返工作岗位的患者中，有16名个体经营者、42名固定员工和3名合同制员工。个体经营者、固定员工和合同制员工的RTW时间分别为5.9±8.8、4.2±4.3和13.3±2.3周（p=0.011）。36名重返工作岗位的患者自我报告术后6个月工作能力下降22.8±15.6%。
RTW可能因就业状况而异。在本研究中，我们发现虽然就业类型可能影响RTW的时间，但大多数患者能够RTW，超过40%的患者报告术后6个月工作能力没有丧失，有望减轻一些患者对LD的顾虑。
