Return to work (RTW) after surgery for cervical radiculopathy occurs primarily during the first year and the strongest predictor of RTW is fewer sick days prior to surgery. This is according to new research, published in the journal Spine by Sozaburo Hara (Norwegian University of Science and Technology, Trondheim, Norway) et al.
The nationwide registry-based observational multicentre study aimed to evaluate sick leave patterns among patients undergoing surgery for cervical radiculopathy and identify predictors of successful RTW—which the study authors note is “increasingly used to assess the standard, benefit, and quality of health care”.
Data from the Norwegian Registry for Spine Surgery (NORspine) and the Norwegian Labour and Welfare Administration were linked on an individual level. Patients between 18 and 60 years of age registered in NORspine from June 2012 through December 2019 that were temporarily out of the labour force for medical reasons at the time of surgery were included. Types and grades of sickness benefits before and after surgery were assessed and logistic regression analyses were conducted.
Out of the 3,387 patients that were included in the study, 851 received temporary benefits one year prior to surgery. The proportion of recipients increased steadily towards surgery.
Postoperatively the medical benefit payment decreased rapidly, and half of the patients had already returned to work by four months. The study found that the rate of RTW reached a plateau at one year and by the end of the third year, 2,429 patients (71.7%) had returned to work.
In addition, the number of sick days—categorised as 90 or less—during the year prior to surgery was found to have the strongest association with RTW at two years (odds ratio [OD] 4.54, 95% confidence interval [CI] 3.42–6.03, p<0.001). Improvement in neck-related disability was the second strongest predictor (OR 2.17, 95% CI 1.69–2.78, p<0.001).
Speaking to Spinal News International, Hara said: “Our findings are yet another contribution to the knowledge of how return to work after neck surgery is not all about disability and pain. Fewer sick days before surgery was the strongest predictor of all the variables we tested, independent of severity of the baseline disability. If the goal of the surgical care is to help the patients back to work, we must focus on their current work status. Remember to ask your patients how they are managing at work.”