Return- to -work(RTW) of Patients after Lumbar Surgery

Abstract

Background: Return to work (RTW) after lumbar surgery due to a work-related injury poses a challenge internationally.  Work hardening is used as an intervention for acute and chronic lower back pain (CLBP), but it is not necessarily used in post-operative treatments.  Method: The RTW rate of an experimental group (Group A) of unskilled labourers was compared with that of a control group (Group B) of unskilled labourers.  Group A received multidisciplinary intervention, including a work hardening programme with ergonomic adaptations, while Group B received only physiotherapy after surgery as a multidisciplinary team was not available.  A RTW questionnaire was used as an outcome measure for both groups.  During the multidisciplinary intervention, the improvement of pain and functionality of patients from Group A were also evaluated from the pre-operative state to 24 weeks post-operatively with the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) as additional outcome measures.  Results: There was a positive tendency to successful RTW after work hardening for Group A, but no statistical significance between Groups A and B.  The improvement of pain and functionality in Group A was highly significant from time of surgery to six months post-operatively.  Conclusion: Work hardening was found to have a positive tendency towards ensuring RTW for work-injured patients after lumbar surgery, with a highly significant effect on pain and functionality. 

 KEY WORDS

Work hardening; work-injured patients; lumbar surgery; return to work (RTW); multidisciplinary approach.