• Ian A Harris, Nandu Dantanarayana, and Justine M Naylor.
• South Western Sydney Clinical School, University of New South Wales, Liverpool, New South Wales, Australia. ianharris@unsw.edu.au
• ANZ J Surg. 2012 Sep 1;82(9):625-9.

IntroductionLumbar spine surgery (fusion, disc replacement or decompression) is common, yet indications are unclear and outcomes, particularly in a workers' compensation setting, are not consistently favourable. This study aimed to determine the outcomes of spine surgery in an Australian workers' compensation cohort.MethodsA retrospective review of prospectively collected data from WorkCover NSW and insurer agents was performed. Subjects were included if they had lumbar spine decompression, fusion or disc replacement procedures performed between 1 January 2004 and 31 December 2006 (inclusive). Main outcome measures were as follows: need for further lumbar spine surgery, return to work (RTW), return to pre-injury duties (PID) and need for ongoing physical treatment or prescription opioids. All outcomes were measured at 24 months post-surgery.ResultsA total of 476 patients had undergone lumbar spine surgery within the workers' compensation system. The revision surgery rate was 9.2%. The RTW rate and return to PID rate were 50.3% and 14.2%, respectively. The proportion of patients still undergoing treatment was 77.7%. The rates of RTW (or PID) and need for ongoing treatment were significantly worse in patients undergoing fusion and disc replacement, compared with patients undergoing decompressive procedures (laminectomy, discectomy).DiscussionThe findings do not support the use of lumbar spine fusion or disc replacement surgery as a method of achieving RTW and relief of pain in patients treated under workers' compensation.© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

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