• Luis M Tumialán, Ryan P Ponton, Anthony I Riccio, and Wayne M Gluf.
• Department of Neurosurgery, Naval Medical Center San Diego, San Diego, California, USA. luis.tumialan@bnaneuro.net
• Neurosurgery. 2012 Aug 1;71(2):317-24; discussion 324.

BackgroundLumbar interbody fusion has been extensively studied in the civilian population; however, data regarding its efficacy in the military are lacking.ObjectiveTo identify the rate of return to unrestricted active military duty after single-level lumbar interbody fusion surgery.MethodsThe surgical database at a single tertiary care military treatment facility was queried for active-duty patients who underwent a single-level lumbar interbody fusion over a 5-year period. A retrospective chart review was performed with backward stepwise logistic regression analysis, and Fisher exact and Wilcoxon rank sum tests were used for statistical analysis.ResultsA total of 102 patients met the inclusion criteria. Mean age at surgery was 34.0 years (range, 19-51 years). Most surgeries (59%) were performed for discogenic pain secondary to degenerative disc disease; the remaining patients underwent surgery for spondylolisthesis (39%) or spinal stenosis (2%). Thirty-nine patients (38%) were treated via an anterior approach (anterior lumbar interbody fusion), whereas 63 patients (62%) underwent fusion via a posterior approach (transforaminal or posterior lumbar interbody fusion). Fifty-six patients (55%) were able to return to unrestricted full active duty, and the remaining 46 patients (45%) were separated from the military. The return to active duty rate was significantly higher in older patients and those ranking E7 (Chief Petty Officer) and above (84.8%).ConclusionFifty-five percent of the service members who underwent a single-level lumbar interbody fusion returned to unrestricted full duty. Older age and higher rank were statistically significant positive predictors of a successful return to active duty.

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