Factors affecting return to work after lumbar disc herniation surgery

The disability caused by the lower back pain is one of the leading factors contributing to work absenteeism. This disability which is usually due to spinal disc herniation prevents an employee from doing his/her daily job, thus creating numerous destructive socioeconomic consequences for him/her as well as the society. The goal of this study is to determine the patients return-to-work rate after undergoing the lumbar disc herniation surgery and to study the related factors.

This study was a cross sectional study. All patients suffered from lumber discetomy from 2005 to 2009 at two TUMS (Tehran University of Medical Sciences) educational hospitals were included in this study. Required data about the patients were gathered from the hospital documents, and the return-to-work rate was evaluated by following up on patients via phone calls. Chi-square and T tests were used for evaluation of quantitative and qualitative variables, respectively.

From 603 final participants, at least 6 month after the surgery, 504 cases (83.6%) returned to work. From these 504 cases, 364 patients (72.2%) returned full time, and 140 patients (27.8%) returned part time. A multivariate regression analysis showed that the return-to-work rate has a strong correlation with age, sex, educational level, body mass index, positive expectation from the surgery before doing it, doctor's encouragement, hospitalization time, manual work, and job satisfaction (p<0.05); however, it had no significant correlation with marriage status, income level, impairmentrequest, insurance coverage, peer support, and the work category with respect to physical labor demand (p>0.05).

Our findings show the importance of work related and psychological factors as the determinants of the return-to-work rate after the lumbar disc surgery. From this study, it is apparent that appropriate strategies and team work (between the patient, the surgeon, the rehabilitation specialist, the occupational medicine specialist, and the employer) would elevate the job satisfaction and positive expectations about the surgery, and therefore, they encourage the patient to return to work at a suitable time which in turn, may increase the total return-to-work rate.