Reduced work capacity after lumbar disc surgery: the role of cognitive-behavioral and work-related risk factors

Pain. 2006 Dec 15;126(1-3):72-8. doi: 10.1016/j.pain.2006.06.010. Epub 2006 Jul 14.

Abstract

A significant number of patients who have had surgery for lumbosacral radicular syndrome still have a reduced work capacity several months later. In a prospective cohort study of 182 people who underwent lumbar disc surgery, we determined the predictive value of preoperatively measured cognitive-behavioral and work-related factors on work capacity 6 months after surgery. Logistic regression analyses indicated that these factors independently predicted work capacity 6 months after surgery. Specifically, fear of movement/(re)injury, more passive pain coping, and higher physical work-load predicted reduced work capacity in multiple logistic regression analyses, taking into account the role of a wide range of control variables including demographic variables, preoperative disability and pain intensity, neurological deficits, intake of analgesics, duration of complaints, and pain intensity 3 days postoperatively. The study supports the need to develop and evaluate preoperative risk screening measures that include both cognitive-behavioral and work-related factors and to evaluate the effectiveness of cognitive-behavioral and work-related interventions in patients at risk of reduced work capacity after surgery for LRS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Aged
  • Back Pain / physiopathology
  • Back Pain / psychology
  • Back Pain / surgery*
  • Cognition
  • Cohort Studies
  • Disability Evaluation*
  • Fear
  • Female
  • Follow-Up Studies
  • Humans
  • Intervertebral Disc / surgery*
  • Logistic Models
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Postoperative Period
  • Prognosis
  • Prospective Studies
  • Time Factors
  • Work Capacity Evaluation*
  • Workload