Objective:

To determine the influence of preoperative workers’ compensation status on patient-reported outcome measures (PROM) following lumbar decompression with or without fusion.

Methods:

All patients undergoing lumbar decompression with or without fusion at a single academic institution between 2013 and 2017 were identified. Patients were split into groups based on workers’ compensation status: no workers’ compensation (NWC), workers’ compensation (WC), or retired (R). Intragroup analysis utilized paired t-tests. Outcomes between groups were compared using a Kruskal-Wallis H test. Multiple linear regression analysis determined if WC status was a predictor of change in PROMs. Subgroup analysis was conducted for WC patients who returned to work.

Results:

Of 571 included patients, 242 were NWC (43.4%), 83 were WC (14.5%) and 246 were R (43.1%). Comparing within groups, WC showed significant improvement in Physical Component Score (PCS-12), Oswestry Disability Index (ODI), Visual Analog Scale (VAS) Back, and VAS Leg (all, p<0.001) following surgery. However, WC patients improved less than NWC or R in PCS-12 (p=0.010), VAS Back (p=0.028), and VAS Leg (p=0.015). WC was an independent predictor of decreased improvement in PCS-12 (β=-4.31, p=0.001), VAS Back (β=0.90, p=0.034), and VAS Leg (β=1.50, p=0.002) on multivariate analysis. WC patients who did not return to work was an independent predictor of decreased improvement in VAS Back (β=1.39, p=0.016) and VAS Leg (β=2.11, p=0.001).

Conclusion:

Patients receiving workers’ compensation improve less than non-workers’ compensation patients. However, workers’ compensation patients who return to work have similar VAS Back and Neck improvements as non-workers’ compensation patients.