Studies indicate workers’ compensation patients fare worse than counterparts following lumbar spine surgery


Two studies recently published in the peer-reviewed Journal of Neurosurgery: Spine have found that workers’ compensation patients undergoing lumbar spine surgery fare worse post-surgery than other patients undergoing the same procedures.

“These studies confirm that workers’ compensation patients are significantly more likely to experience greater pain and residual disability, as well as delayed return to work, than other patients who have the same procedures,” noted Gerry Stanley, chief medical officer at Harvard MedTech—an author on both studies. “Consequently, these patients experienced a lower quality of life, higher cost for treatment, and a greater likelihood of reliance on addictive pain medications.”

The results of the studies are set to be discussed at the National Workers’ Compensation and Disability (NWCD) conference (20–22 September, Las Vegas, USA) in a presentation entitled, “Follow the Patient Journey: Sidestep Pitfalls Throughout the Life of a Claim”.

The more recent of these two articles, published in July this year, analysed 9,957 patients who had had 1–4-level anterior cervical discectomy and fusion (ACDF). One-year postoperative improvements, return-to-work rates and satisfaction were all significantly lower for workers’ compensation compared with non-workers’ compensation patients, even though the former patient group had fewer comorbidities and were younger.

Another previous article, published in March, evaluated 29,500 cases, and also found that workers’ compensation patients were significantly more likely to experience greater pain and residual disability, as well as a delayed return to work, than other patients.

The largest study of its kind to date—as per a press release from Harvard Medtech—the research focused on data compiled from patients who underwent 1–4-level lumbar spinal fusion or decompression alone, as reported to the Quality Outcomes Database (QOD). The data included one-year patient-reported outcomes from more than 200 hospital systems between 2012 and 2021. All patients complained of back pain prior to surgery.

The workers’ compensation cohort was younger, more overweight, and less likely to have a college or postgraduate education, than the non-workers’ compensation population; while workers’ compensation patients were also twice as likely to be smokers.

While the study theorised that the reasons for worse outcomes in the workers’ compensation patients could be multifactorial—such as injury severity, socioeconomic factors, and biopsychosocial behaviour like exacerbated illness promoting disability payments—it concluded that identifying the causes for the negative effects on these patients could yield better outcomes.

In its recent release, Harvard Medtech claims that these two studies “confirm what has long been suspected” by indicating that workers’ compensation patients generally do worse than their non-workers’ compensation counterparts following lumbar spine surgery.


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