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Spinal Outcomes Linked to Pre-Surgery Time Off

Last Updated: May 11, 2009.

Patients with symptomatic disc degeneration have a greater improvement in pain and disability after surgery if they were off work less than 13 weeks before surgery, according to a study in the May issue of The Spine Journal.

MONDAY, May 11 (HealthDay News) -- Patients with symptomatic disc degeneration have a greater improvement in pain and disability after surgery if they were off work less than 13 weeks before surgery, according to a study in the May issue of The Spine Journal.

Michael X. Rohan Jr., D.O., and colleagues from the Texas Back Institute Research Foundation in Plano analyzed data from a clinical trial involving 204 patients with symptomatic disc degeneration who had been randomly assigned to total disc replacement or lumbar fusion.

The researchers found that patients who had been off work for 13 weeks or less before surgery had better clinical outcomes, as assessed by visual analog scales and Oswestry disability index scores 24 months after surgery, than patients who had been off work for longer periods. Although patients who had been off work for more than 13 weeks before surgery still improved, the improvement was lower than that for patients who had been off work for shorter periods.

"This study suggests a window of approximately 13 weeks off work before surgery after which clinical improvement is reduced," Rohan and colleagues conclude. "Implications of this finding may be that once a patient becomes unable to work for an extended period, more rigorous psychological screening may be in order as well as perhaps engaging in more rigorous rehabilitation after surgery."

Several authors reported an affiliation with Synthes Spine and DePuy Spine.

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