Laurén Jenna L C, Toivonen Leevi A, Repo Jussi P, Kautiainen Hannu, Häkkinen Arja H, Neva Marko H
Department of Orthopaedics and Trauma, Tampere University Hospital, Tampere; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Primary Health Care Unit, Kuopio University Hospital, Kuopio; Folkhälsan Research Center, Helsinki, Finland.
Acta Orthop. 2025 Aug 15;96:612-617. doi: 10.2340/17453674.2025.43751.
Return to work is an important objective and measure of treatment success in the working-age population. Many patient-related factors have been shown to be associated with failure to resume working postoperatively. The aim of this longitudinal database study was to determine return to work rates in a 24-month follow-up after lumbar fusion. We also evaluated whether return to work was affected by the physical demand of work or the preoperative dominance of leg or back pain.
348 consecutive patients available to the workforce underwent lumbar fusion. Return to work at 12 and 24 months was evaluated by patient questionnaires. Patients rated the physical demand of work into 3 categories: light, moderately demanding, or demanding. The surgeon identified the predominant symptom preoperatively, dividing patients into back and leg pain groups.
Return to work was 69% (95% confidence interval [CI] 64-73) and 76% (CI 71-81), at 12- and 24-month follow-ups, respectively. Patients in physically demanding work were less likely to resume working than patients in light work (63% vs 86% at 24 months, respectively). The predominant symptom did not affect return to work.
In patients of working age, three-quarters of lumbar spine fusion patients returned to work within 2 years of surgery. Work absenteeism was higher in physically demanding occupations and only 60% of the patients with predominant leg pain returned to their physically heavy occupation in the first year following lumbar fusion.
重返工作岗位是劳动年龄人群治疗成功的重要目标和衡量标准。许多与患者相关的因素已被证明与术后无法恢复工作有关。这项纵向数据库研究的目的是确定腰椎融合术后24个月的重返工作率。我们还评估了重返工作是否受到工作体力需求或术前腿痛或背痛占主导地位的影响。
348例可供劳动力使用的连续患者接受了腰椎融合术。通过患者问卷评估12个月和24个月时的重返工作情况。患者将工作的体力需求分为3类：轻松、中等需求或高需求。外科医生在术前确定主要症状，将患者分为背痛组和腿痛组。
在12个月和24个月的随访中，重返工作的比例分别为69%（95%置信区间[CI]64-73）和76%（CI 71-81）。从事体力要求高的工作的患者比从事轻松工作的患者恢复工作的可能性更小（24个月时分别为63%和86%）。主要症状不影响重返工作。
在劳动年龄患者中，四分之三的腰椎融合患者在术后2年内重返工作岗位。体力要求高的职业缺勤率更高，在腰椎融合后的第一年，只有60%主要腿痛的患者恢复了体力要求高的职业。
