Predicting Return to Work After Lumbar Discectomy

A presentation at the 2015 American Association of Neurological Surgeons Annual Scientific Meeting

Newswise — WASHINGTON, D.C. (May 4, 2015) — Winner of the Stewart B. Dunsker, MD, Award, Khoi Duc Than, MD, presented his research, How to Predict Return to Work After Lumbar Discectomy: Answers from the NeuroPoint SD Registry.

To date, the factors that predict whether a patient returns to work after lumbar discectomy are unknown. Gathering information on postoperative work status is important in analyzing a procedure’s cost effectiveness.

Researchers completed an observational prospective cohort study at 13 academic and community sites (NeuroPoint-SD registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, gender, BMI, SF-36 physical function score, ODI, diabetes, smoking status, systemic illness, workers compensation status and preoperative work status. The primary outcome was working status within three months after surgery. Logistic regression analysis was performed to determine which factors were predictive of return to work at three months following discectomy.

There were 127 patients (out of 148 total) with data collected at three months postoperatively. Average age was 46 +/- 1 years, and 66.9 percent of patients were working at three months postoperatively. Statistical analysis demonstrated that those more likely to return to work were patients of younger age, males, those with higher SF-36 physical function scores, those with lower ODI, non-smokers and those who were working preoperatively. Logistic regression analysis found that gender and preoperative work status were the most important factors. When controlling for those who were working preoperatively (89 patients), only age was a statistically significant predictor of postoperative return to work.

In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status three months after surgery. Factors not influencing return to work in the logistic regression analysis included gender, BMI, SF-36 physical function score, ODI, diabetes, smoking status and systemic illness. There was not enough information regarding workers compensation status to draw conclusions regarding that variable.

Author Block: Jill Curran; Daniel Resnick, MD, FAANS; Christopher Shaffrey, MD, FAANS; Zoher Ghogawala, MD, FAANS; Praveen Mummaneni, MD, FAANS.

Disclosure: The author reported no conflicts of interest.

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About the 2015 AANS Annual Scientific Meeting: Attended by neurosurgeons, neurosurgical residents, medical students, neuroscience nurses, clinical specialists, physician assistants, allied health professionals and other medical professionals, the AANS Annual Scientific Meeting is the largest gathering of neurosurgeons in the nation, with an emphasis on the field’s latest research and technological advances. More than 1,200 scientific abstracts were presented for review at the 2015 AANS Annual Scientific Meeting, and the scientific presentations given at this year’s event represent cutting-edge examples of the incredible developments taking place within the field of neurosurgery. Additional information about the 2015 AANS Annual Scientific Meeting and the meeting program can be found here.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 9,000 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada, or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves.

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