Return to work after surgery for lumbar disc herniation, secondary analyses from a randomized controlled trial comparing supervised rehabilitation versus home exercises

Rune Tendal Paulsen, Jesper Rasmussen, Leah Y Carreon, Mikkel Østerheden Andersen

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND CONTEXT: Patients undergoing lumbar discectomy are typically referred for postoperative rehabilitation. However, evidence regarding effectiveness of postoperative rehabilitation to improve surgical outcome and hasten return to work is scarce with conflicting results in the published literature.

PURPOSE: This study investigates the effect of postoperative rehabilitation on return to work, duration of sick leave and working ability after surgery for lumbar disc herniation.

STUDY DESIGN/SETTING: Single center randomized controlled trial.

PATIENT SAMPLE: Patients scheduled for primary discectomy due to lumbar disc herniation were included in the study.

OUTCOME MEASURES: Self-reported measures included working ability, work status and job type defined by the International Standard Classification of Occupations. All outcomes including duration of sick leave were obtained from follow-up questionnaires at one and two years after surgery.

METHODS: This is a secondary analysis from a randomized controlled trial comparing patients who were referred to rehabilitation at the municipal facility starting 4-6 weeks postoperative (REHAB) and patients sent home after surgery without any planned rehabilitation course (HOME). Linear regression was performed to identify baseline characteristics associated with duration of sick leave.

RESULTS: One hundred forty-six patients were included and equally distributed between the groups. Follow-up rate was 78% after one and two years. Both groups had a similar postoperative sick leave period of approximately 9 weeks. After one year 79% had returned to work in the HOME-group versus 74% in the REHAB-group, which was not statistically significant. Working ability improved from baseline to one year in both groups and this improvement was sustained at two-year follow-up. Stepwise linear regression showed that preoperative duration of leg pain and working ability were associated with duration of postoperative sick leave.

CONCLUSIONS: Referral for unstandardized municipal rehabilitation does not affect duration of postoperative sick leave, return to work or working ability in patients recovering after surgery for lumbar disc herniation. Duration of preoperative leg pain and preoperative working ability was significantly associated with the duration of postoperative sick leave.

Original languageEnglish
JournalThe Spine Journal
ISSN1529-9430
DOIs
Publication statusE-pub ahead of print - 23. Sep 2019

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Sick Leave
Return to Work
Randomized Controlled Trials
Exercise
Linear Models
Leg
Occupations
Referral and Consultation

Cite this

@article{ec34658e6a09498b8d495619a6c7c5b5,
title = "Return to work after surgery for lumbar disc herniation, secondary analyses from a randomized controlled trial comparing supervised rehabilitation versus home exercises",
abstract = "BACKGROUND CONTEXT: Patients undergoing lumbar discectomy are typically referred for postoperative rehabilitation. However, evidence regarding effectiveness of postoperative rehabilitation to improve surgical outcome and hasten return to work is scarce with conflicting results in the published literature.PURPOSE: This study investigates the effect of postoperative rehabilitation on return to work, duration of sick leave and working ability after surgery for lumbar disc herniation.STUDY DESIGN/SETTING: Single center randomized controlled trial.PATIENT SAMPLE: Patients scheduled for primary discectomy due to lumbar disc herniation were included in the study.OUTCOME MEASURES: Self-reported measures included working ability, work status and job type defined by the International Standard Classification of Occupations. All outcomes including duration of sick leave were obtained from follow-up questionnaires at one and two years after surgery.METHODS: This is a secondary analysis from a randomized controlled trial comparing patients who were referred to rehabilitation at the municipal facility starting 4-6 weeks postoperative (REHAB) and patients sent home after surgery without any planned rehabilitation course (HOME). Linear regression was performed to identify baseline characteristics associated with duration of sick leave.RESULTS: One hundred forty-six patients were included and equally distributed between the groups. Follow-up rate was 78{\%} after one and two years. Both groups had a similar postoperative sick leave period of approximately 9 weeks. After one year 79{\%} had returned to work in the HOME-group versus 74{\%} in the REHAB-group, which was not statistically significant. Working ability improved from baseline to one year in both groups and this improvement was sustained at two-year follow-up. Stepwise linear regression showed that preoperative duration of leg pain and working ability were associated with duration of postoperative sick leave.CONCLUSIONS: Referral for unstandardized municipal rehabilitation does not affect duration of postoperative sick leave, return to work or working ability in patients recovering after surgery for lumbar disc herniation. Duration of preoperative leg pain and preoperative working ability was significantly associated with the duration of postoperative sick leave.",
author = "Paulsen, {Rune Tendal} and Jesper Rasmussen and Carreon, {Leah Y} and Andersen, {Mikkel {\O}sterheden}",
note = "Copyright {\circledC} 2019. Published by Elsevier Inc.",
year = "2019",
month = "9",
day = "23",
doi = "10.1016/j.spinee.2019.09.019",
language = "English",
journal = "The Spine Journal",
issn = "1529-9430",
publisher = "Elsevier",

}

TY - JOUR

T1 - Return to work after surgery for lumbar disc herniation, secondary analyses from a randomized controlled trial comparing supervised rehabilitation versus home exercises

AU - Paulsen, Rune Tendal

AU - Rasmussen, Jesper

AU - Carreon, Leah Y

AU - Andersen, Mikkel Østerheden

N1 - Copyright © 2019. Published by Elsevier Inc.

PY - 2019/9/23

Y1 - 2019/9/23

N2 - BACKGROUND CONTEXT: Patients undergoing lumbar discectomy are typically referred for postoperative rehabilitation. However, evidence regarding effectiveness of postoperative rehabilitation to improve surgical outcome and hasten return to work is scarce with conflicting results in the published literature.PURPOSE: This study investigates the effect of postoperative rehabilitation on return to work, duration of sick leave and working ability after surgery for lumbar disc herniation.STUDY DESIGN/SETTING: Single center randomized controlled trial.PATIENT SAMPLE: Patients scheduled for primary discectomy due to lumbar disc herniation were included in the study.OUTCOME MEASURES: Self-reported measures included working ability, work status and job type defined by the International Standard Classification of Occupations. All outcomes including duration of sick leave were obtained from follow-up questionnaires at one and two years after surgery.METHODS: This is a secondary analysis from a randomized controlled trial comparing patients who were referred to rehabilitation at the municipal facility starting 4-6 weeks postoperative (REHAB) and patients sent home after surgery without any planned rehabilitation course (HOME). Linear regression was performed to identify baseline characteristics associated with duration of sick leave.RESULTS: One hundred forty-six patients were included and equally distributed between the groups. Follow-up rate was 78% after one and two years. Both groups had a similar postoperative sick leave period of approximately 9 weeks. After one year 79% had returned to work in the HOME-group versus 74% in the REHAB-group, which was not statistically significant. Working ability improved from baseline to one year in both groups and this improvement was sustained at two-year follow-up. Stepwise linear regression showed that preoperative duration of leg pain and working ability were associated with duration of postoperative sick leave.CONCLUSIONS: Referral for unstandardized municipal rehabilitation does not affect duration of postoperative sick leave, return to work or working ability in patients recovering after surgery for lumbar disc herniation. Duration of preoperative leg pain and preoperative working ability was significantly associated with the duration of postoperative sick leave.

AB - BACKGROUND CONTEXT: Patients undergoing lumbar discectomy are typically referred for postoperative rehabilitation. However, evidence regarding effectiveness of postoperative rehabilitation to improve surgical outcome and hasten return to work is scarce with conflicting results in the published literature.PURPOSE: This study investigates the effect of postoperative rehabilitation on return to work, duration of sick leave and working ability after surgery for lumbar disc herniation.STUDY DESIGN/SETTING: Single center randomized controlled trial.PATIENT SAMPLE: Patients scheduled for primary discectomy due to lumbar disc herniation were included in the study.OUTCOME MEASURES: Self-reported measures included working ability, work status and job type defined by the International Standard Classification of Occupations. All outcomes including duration of sick leave were obtained from follow-up questionnaires at one and two years after surgery.METHODS: This is a secondary analysis from a randomized controlled trial comparing patients who were referred to rehabilitation at the municipal facility starting 4-6 weeks postoperative (REHAB) and patients sent home after surgery without any planned rehabilitation course (HOME). Linear regression was performed to identify baseline characteristics associated with duration of sick leave.RESULTS: One hundred forty-six patients were included and equally distributed between the groups. Follow-up rate was 78% after one and two years. Both groups had a similar postoperative sick leave period of approximately 9 weeks. After one year 79% had returned to work in the HOME-group versus 74% in the REHAB-group, which was not statistically significant. Working ability improved from baseline to one year in both groups and this improvement was sustained at two-year follow-up. Stepwise linear regression showed that preoperative duration of leg pain and working ability were associated with duration of postoperative sick leave.CONCLUSIONS: Referral for unstandardized municipal rehabilitation does not affect duration of postoperative sick leave, return to work or working ability in patients recovering after surgery for lumbar disc herniation. Duration of preoperative leg pain and preoperative working ability was significantly associated with the duration of postoperative sick leave.

U2 - 10.1016/j.spinee.2019.09.019

DO - 10.1016/j.spinee.2019.09.019

M3 - Journal article

JO - The Spine Journal

JF - The Spine Journal

SN - 1529-9430

ER -