Spine surgery outcomes in a workers' compensation cohort

ANZ J Surg. 2012 Sep;82(9):625-9. doi: 10.1111/j.1445-2197.2012.06152.x. Epub 2012 Aug 7.


Introduction: Lumbar spine surgery (fusion, disc replacement or decompression) is common, yet indications are unclear and outcomes, particularly in a workers' compensation setting, are not consistently favourable. This study aimed to determine the outcomes of spine surgery in an Australian workers' compensation cohort.

Methods: A retrospective review of prospectively collected data from WorkCover NSW and insurer agents was performed. Subjects were included if they had lumbar spine decompression, fusion or disc replacement procedures performed between 1 January 2004 and 31 December 2006 (inclusive). Main outcome measures were as follows: need for further lumbar spine surgery, return to work (RTW), return to pre-injury duties (PID) and need for ongoing physical treatment or prescription opioids. All outcomes were measured at 24 months post-surgery.

Results: A total of 476 patients had undergone lumbar spine surgery within the workers' compensation system. The revision surgery rate was 9.2%. The RTW rate and return to PID rate were 50.3% and 14.2%, respectively. The proportion of patients still undergoing treatment was 77.7%. The rates of RTW (or PID) and need for ongoing treatment were significantly worse in patients undergoing fusion and disc replacement, compared with patients undergoing decompressive procedures (laminectomy, discectomy).

Discussion: The findings do not support the use of lumbar spine fusion or disc replacement surgery as a method of achieving RTW and relief of pain in patients treated under workers' compensation.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cohort Studies
  • Decompression, Surgical
  • Diskectomy
  • Female
  • Humans
  • Intervertebral Disc Displacement / surgery*
  • Laminectomy
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • New South Wales
  • Orthopedic Procedures*
  • Recovery of Function
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Return to Work
  • Spinal Fusion
  • Total Disc Replacement
  • Treatment Outcome
  • Workers' Compensation*
  • Young Adult