Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere, Finland.
Department of Orthopedics and Traumatology, Turku University Hospital and University of Turku, Turku, Finland.
Acta Orthop. 2021 Dec;92(6):638-643. doi: 10.1080/17453674.2021.1951010. Epub 2021 Jul 16.
Background and purpose - Lumbar disc herniation is a common surgically treated condition in the working-age population. We assessed health-related risk factors for return to work (RTW) after excision of lumbar disc herniation. Previous studies on the subject have had partly contradictory findings.Patients and methods - RTW of 389 (n = 111 male, n = 278 female; mean age 46 years, SD 8.9) employees who underwent excision of lumbar disc herniation was assessed based on the Finnish Public Sector Study (FPS). Baseline information on occupation, preceding health, and health-risk behaviors was derived from linkage to national health registers and FPS surveys before the operation. The likelihood of RTW was analyzed using Cox proportional hazard univariable and multivariable modelling.Results - 95% of the patients had returned to work at 12 months after surgery, after on average 78 days of sickness absence. Faster RTW in the univariable Cox model was associated with a small number of sick leave days (< 30 days) before operation (HR 1.3, 95% CI 1.1-1.6); high occupational position (HR 1.6, CI 1.2-2.1); and age under 40 years (HR 1.5, CI 1.1-1.9). RTW was not associated with sex or the health-related risk factors obesity, physical inactivity, smoking, heavy alcohol consumption, poor self-rated health, psychological distress, comorbid conditions, or purchases of pain or antidepressant medications in either the univariable or multivariable model.Interpretation - Almost all employees returned to work after excision of lumbar disc herniation. Older age, manual job, and prolonged sick leave before the excision of lumbar disc herniation were risk factors for delayed return to work after the surgery.
背景与目的 - 腰椎间盘突出症是工作年龄段人群中常见的手术治疗病症。我们评估了腰椎间盘突出症切除术后重返工作岗位（RTW）的与健康相关的危险因素。该主题的先前研究结果存在部分矛盾。
患者和方法 - 根据芬兰公共部门研究（FPS），评估了 389 名（男 111 名，女 278 名；平均年龄 46 岁，SD 8.9）接受腰椎间盘突出症切除术的员工的 RTW。手术前，通过与国家健康登记册和 FPS 调查的链接，获得了有关职业、先前健康和健康风险行为的基线信息。使用 Cox 比例风险单变量和多变量模型分析 RTW 的可能性。
结果 - 手术后 12 个月，95%的患者已经重返工作岗位，平均病假 78 天后。在单变量 Cox 模型中，更快的 RTW 与手术前较短的病假天数（<30 天）（HR 1.3，95%CI 1.1-1.6）、高职业地位（HR 1.6，CI 1.2-2.1）和 40 岁以下年龄（HR 1.5，CI 1.1-1.9）相关。RTW 与性别或肥胖、身体活动不足、吸烟、大量饮酒、自我报告健康状况差、心理困扰、合并症或在单变量或多变量模型中购买止痛或抗抑郁药物等健康相关危险因素无关。
解释 - 几乎所有员工在接受腰椎间盘突出症切除术后都重返工作岗位。年龄较大、体力劳动和手术前的病假时间延长是手术后 RTW 延迟的危险因素。
