Return to work after lumbar disc herniation surgery: an occupational cohort study

Mapping the conceptual structure of ergonomics, musculoskeletal disorders, treatment and return to work in manual jobs: A systematic review

BACKGROUND

Musculoskeletal disorders constitute one of the major health problems of workers exposed to manual work throughout the world. Nevertheless, there is no study that maps its conceptual structure based on a systematic methodology.

OBJECTIVE

To identify the conceptual structure of ergonomics, MSDs, treatment and return to work in manual jobs in the last 12 years by applying a systematic co-word network analysis methodology which describes the replicability of the search filters and emphasizes the rigor that has to be followed in the creation of the network.

METHODS

The search filter was customized for each bibliographic database, and followed the PRISMA 2020 flowchart for the screening process. For the creation of the network, the titles, abstracts, and keywords were used as the unit of analysis extracting the noun phrases of the first two units. In the normalization process, the terms of the search filter were deleted and their associated terms, and standardized the similar terms. Regarding the plotting of the network, Vosviewer was used applying the network settings based on content analysis.

RESULTS

The co-word network shows three communities: Ergonomic assessment and workplace intervention tools, factors related to rehabilitation and return to work, and physical and mental overload management. For each community, there is a framework that explains the relationship within terms.

CONCLUSION

This study is aligned with the replicability, robustness, and relevance recommendations in the implementation of rigorous scientometric studies. The occupational health community is encouraged to implement scientometric studies following a rigorous methodology and working in interdisciplinary team.

Factors affecting return to work following endoscopic lumbar foraminal stenosis surgery: A single-center series

Background

This study evaluates the factors affecting the return to work of endoscopic surgery for lumbar foraminal stenosis (LFS), including symptoms, functional status, complications, and reoperation rates.

Methods

The authors' retrospective cohort study included 100 consecutive patients (50 males and 50 females) diagnosed with LFS who underwent endoscopic surgery at Trotsky National Research Center of Surgery between January 2018 and December 2021.

Results

There were no significant differences in age and preoperative visual analog scale and Oswestry disability index scores between the male and female groups, time to return to work for different patient groups after undergoing endoscopic lumbar foraminotomy (ELF). However, patients with more severe stenosis and comorbidities may take longer to recover. Confounding factors were patient age, preoperative physical function, and job requirements.

Conclusion

This study confirms that study ELF can effectively improve symptoms associated with lumbar radiculopathy, as well as back pain, and improve patients' quality of life. Comorbidity, smoking status, and complications prolong the time to return to work following ELF surgery compared to healthy subjects.

Postoperative recommendations for single-level lumbar disc herniation: a cross-section survey

BACKGROUND

Lumbar degenerative disc disease is one of the leading causes of low back and leg pain. Conservative treatment is the mainstay treatment, but for some patients surgical approach is required. The literature concerning postoperative recommendations on patients' return to work is sparse. The aim of this study is to assess spine surgeons' consensus regarding postoperative recommendations, including return to work, restart of daily-living activities, analgesic medication usage and rehabilitation referral.

METHODS

An online GoogleForms survey was sent, via electronic mail, during January 2022, to 243 surgeons described as having expertise in spine surgery, using the dissemination means of Sociedade Portuguesa de Patologia da Coluna Vertebral and Sociedade Portuguesa de Neurocirurgia. Participants (n = 59) had predominantly hybrid clinical practice in Neurosurgery field.

RESULTS

Only in a minority of cases (1.7%) no recommendation was given to patients. Nearly 68% of participants advised patients to return to sedentary professional work up until the 4th postoperative week. Light and heavy workload workers were advised to wait longer until initiating work activity. Low mechanical impact activities are started up to 4 weeks, and higher stress activities should be further postponed. Half of the surveyed surgeons estimates to refer to rehabilitation 10% or more patients. No differences were found when comparing recommendations given by more and less experienced surgeons-as defined by number of years in practice and number of annual surgeries-for most activities.

CONCLUSION

Despite not having clear guidelines in postoperative management of surgically treated patients, Portuguese practice is in line with international experience and literature.

Neurosurgeons Relate Heterogeneous Practices Regarding Activity and Return to Work After Spine Surgery

OBJECTIVE

Given the paucity of relevant data, the Council of State Neurosurgical Societies Workforce Committee launched a survey of neurosurgeons to assess patterns in activity restriction recommendations following spine surgery; the ultimate goal was to optimize and potentially standardize these recommendations. The aim of this initial study was to determine current practices in activity restrictions and return to work guidelines following common spinal procedures.

METHODS

The survey included questions regarding general demographics and practice data, postoperative bracing/orthosis utilization, and guidelines for postoperative return to different levels of activity/types of work following specific spine surgery interventions. A spectrum of typical spine surgeries was assessed, including microdiscectomy, anterior cervical discectomy and fusion (ACDF), and lumbar fusion, both open and minimal invasive surgery (MIS) approaches.

RESULTS

There was significant interprocedure and intraprocedure variation in the neurosurgeons' recommendations for postoperative activity and return to work recommendations after various spinal surgery procedures. Comparisons of the different surgical procedures evaluated revealed significant differences in cervical collar use (more often used following ≥2-level ACDF than single-level ACDF; P < 0.001), return to both sedentary and light physical work (greater restriction with ≥2-level ACDF than with single-level ACDF; P < 0.001), and return to a light exercise regimen (sooner following MIS versus open lumbar fusion; P < 0.001).

CONCLUSIONS

This survey demonstrated little consistency regarding return to work recommendations, general activity restrictions, and orthosis utilization following common spinal surgical procedures. Addressing this issue also has significant implications for the societal and personal costs of spine surgery.