Characteristics of patients who return to work after undergoing surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

dc.contributor.author

Bergin, Stephen M

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Michalopoulos, Giorgos D

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Shaffrey, Christopher I

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Gottfried, Oren N

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Johnson, Eli

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Bisson, Erica F

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Wang, Michael Y

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Knightly, John J

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Virk, Michael S

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Tumialán, Luis M

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Turner, Jay D

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Upadhyaya, Cheerag D

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Shaffrey, Mark E

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Park, Paul

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Foley, Kevin T

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Coric, Domagoj

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Slotkin, Jonathan R

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Potts, Eric A

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Chou, Dean

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Fu, Kai-Ming G

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Haid, Regis W

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Asher, Anthony L

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Bydon, Mohamad

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Mummaneni, Praveen V

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Than, Khoi D

dc.date.accessioned

2023-06-13T23:00:41Z

dc.date.available

2023-06-13T23:00:41Z

dc.date.issued

2023-05

dc.date.updated

2023-06-13T23:00:40Z

dc.description.abstract

Objective

Return to work (RTW) is an important surgical outcome for patients who are employed, yet a significant number of patients with cervical spondylotic myelopathy (CSM) who are employed undergo cervical spine surgery and fail to RTW. In this study, the authors investigated factors associated with failure to RTW in the CSM population who underwent cervical spine surgery and who were considered to have a good surgical outcome yet failed to RTW.

Methods

This study retrospectively analyzed prospectively collected data from the cervical myelopathy module of a national spine registry, the Quality Outcomes Database. The CSM data set of the Quality Outcomes Database was queried for patients who were employed at the time of surgery and planned to RTW postoperatively. Distinct multivariable logistic regression models were fitted with 3-month RTW as an outcome for the overall population to identify risk factors for failure to RTW. Good outcomes were defined as patients who had no adverse events (readmissions or complications), who had achieved 30% improvement in Neck Disability Index score, and who were satisfied (North American Spine Society satisfaction score of 1 or 2) at 3 months postsurgery.

Results

Of the 409 patients who underwent surgery, 80% (n = 327) did RTW at 3 months after surgery. At 3 months, 56.9% of patients met the criteria for a good surgical outcome, and patients with a good outcome were more likely to RTW (88.1% vs 69.2%, p < 0.01). Of patients with a good outcome, 11.9% failed to RTW at 3 months. Risk factors for failing to RTW despite a good outcome included preoperative short-term disability or leave status (OR 3.03 [95% CI 1.66-7.90], p = 0.02); a higher baseline Neck Disability Index score (OR 1.41 [95% CI 1.09-1.84], p < 0.01); and higher neck pain score at 3 months postoperatively (OR 0.81 [95% CI 0.66-0.99], p = 0.04).

Conclusions

Most patients with CSM who undergo spine surgery reenter the workforce within 3 months from surgery, with RTW rates being higher among patients who experience good outcomes. Among patients with good outcomes who were employed, failure to RTW was associated with being on preoperative short-term disability or leave status prior to surgery as well as higher neck pain scores at baseline and at 3 months postoperatively.
dc.identifier.issn

1547-5654

dc.identifier.issn

1547-5646

dc.identifier.uri

https://hdl.handle.net/10161/27934

dc.language

eng

dc.publisher

Journal of Neurosurgery Publishing Group (JNSPG)

dc.relation.ispartof

Journal of neurosurgery. Spine

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10.3171/2023.1.spine221078

dc.subject

Cervical Vertebrae

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Humans

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Spinal Cord Diseases

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Neck Pain

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Treatment Outcome

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Retrospective Studies

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Return to Work

dc.title

Characteristics of patients who return to work after undergoing surgery for cervical spondylotic myelopathy: a Quality Outcomes Database study.

dc.type

Journal article

duke.contributor.orcid

Shaffrey, Christopher I|0000-0001-9760-8386

pubs.begin-page

530

pubs.end-page

539

pubs.issue

5

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Orthopaedic Surgery

pubs.organisational-group

Neurosurgery

pubs.publication-status

Published

pubs.volume

38

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