Posted by: Steven J. Picardi
Date: November 6, 2012
A study published in 2010 in the international medical journal SPINE compared the outcomes of 725 work comp lumbar fusion cases to 725 randomly selected work comp chronic low back pain patients not undergoing surgery. While this may be something that will come as no surprise to anyone familiar with workers’ compensation claims, the study concluded that lumbar fusion for the diagnoses of disc degeneration, disc herniation, and/or radiculopathy in a workers’ compensation setting “is associated with significant increase in disability, opiate use, prolonged work loss, and poor [Return to Work] status.” Specifically, the study found, among other things: only 26 % of claimants undergoing fusion surgery had returned to work within two years of the fusion, while 67% of non-surgical claimants returned to work within two years of the date of injury; daily opioid use increased 41% after lumbar fusion surgery, with 76% of claimants receiving surgery continuing opioid use after surgery; both current smoking and legal representation were significant negative predictors of Return To Work; and claimants without legal representation were 3 times more likely to Return to Work than claimants with legal representation. Long-term Outcomes of Lumbar Fusion Among Workers’ Compensation Subjects, An Historical Cohort Study, SPINE Volume XX, Number XX [© 2010, Lippincott Williams & Wilkins].
While the usefulness of this particular study may be limited in any particular case, the results of this study should be considered whenever an adjuster is considering authorizing a lumbar fusion for the specific diagnosis of disc degeneration, disc herniation and/or radiculopathy in a workers’ compensation claim. If you would like a copy of this article, please feel free to contact me.