The 364 patients included in the study from the Ohio Workers Compensation database either underwent primary decompression or primary decompression and fusion between 1993 and 2013. The study authors found:
1. The decompression only patients reported a higher return to work rate — 36 percent, compared with 25 percent in the fusion group.
2. Fusion was a negative predictor of return to work status, as demonstrated by a logistic regression model.
3. The rate of postoperative instability and subsequent fusion among the decompression-only patients was 8 percent.
4. The cost for patients undergoing fusions was $46,115 through three years after surgery when compared with the patients who only underwent decompressions.
5. The study authors concluded fusion had a “significantly negative impact” on the outcomes for workers compensation patients. “The results demonstrate the high risk of postoperative morbidity associated with fusion procedures and underscore the need to strongly reevaluate the use of fusion for DLS without instability in the WC population.”
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