Early Predictors of Lumbar Spine Surgery After Occupational Back Injury

作者：Benjamin J. Keeney, Deborah Fulton‐Kehoe, Judith Axler Turner, Thomas M. Wickizer, Kwun Chuen Gary Chan, Gary M. Franklin · 发表于：Spine · 年份：2012 · DOI：10.1097/brs.0b013e3182814ed5 · 被引用次数：54 · 研究领域：Spine and Intervertebral Disc Pathology、Musculoskeletal pain and rehabilitation、Spinal Fractures and Fixation Techniques

STUDY DESIGN: Prospective population-based cohort study. OBJECTIVE: To identify early predictors of lumbar spine surgery within 3 years after occupational back injury. SUMMARY OF BACKGROUND DATA: Back injuries are the most prevalent occupational injury in the United States. Few prospective studies have examined early predictors of spine surgery after work-related back injury. METHODS: Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers, with new workers compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The area under the receiver operating characteristic curve of the model was used to determine the model's ability to identify correctly workers who underwent surgery. RESULTS: In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the in...