Journal
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
Volume 18, Issue 11, Pages -Publisher
MDPI
DOI: 10.3390/ijerph18116165
Keywords
disability; insurance; low back pain; lumbar decompression; lumbar fusion; musculoskeletal disorders; occupational health; pain; return to work; satisfaction
Funding
- ItalianWorkers' Compensation Authority (INAIL) [BRiC-2018 ID3]
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Patients receiving workers' compensation show higher post-operative pain and disability, lower satisfaction after surgery, and delayed return to work compared to those without workers' compensation after lumbar spine surgery.
Low back pain (LBP) is currently the leading cause of disability worldwide and the most common reason for workers' compensation (WC) claims. Studies have demonstrated that receiving WC is associated with a negative prognosis following treatment for a vast range of health conditions. However, the impact of WC on outcomes after spine surgery is still controversial. The aim of this meta-analysis was to systematically review the literature and analyze the impact of compensation status on outcomes after lumbar spine surgery. A systematic search was performed on Medline, Scopus, CINAHL, EMBASE and CENTRAL databases. The review included studies of patients undergoing lumbar spine surgery in which compensation status was reported. Methodological quality was assessed through ROBINS-I and quality of evidence was estimated using the GRADE rating. A total of 26 studies with a total of 2668 patients were included in the analysis. WC patients had higher post-operative pain and disability, as well as lower satisfaction after surgery when compared to those without WC. Furthermore, WC patients demonstrated to have a delayed return to work. According to our results, compensation status is associated with poor outcomes after lumbar spine surgery. Contextualizing post-operative outcomes in clinical and work-related domains helps understand the multifactorial nature of the phenomenon.
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