The study included 331 WC patients who underwent lumbar fusion and 233 patients who underwent non-surgical care. The fusion group had a longer length of disability when compared with the non-fusion group.
However, the groups differed significantly after surgery on the diagnosis of major depressive disorder and opioid dependence. Patients with pre-rehab opioid dependence had lower rates of work return and work retention and higher rates of treatment-seeking behavior. The higher levels of perceived disability and depressive symptoms pre-rehab were also risk factors for poor return to work and retention, according to the report.
The authors suggested surgeons may be able to improve lumbar surgery outcomes among WC patients if they control post-operative opioid dependence and prevent excessive length of disability.
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