Reduced work capacity after lumbar disc surgery: the role of cognitive-behavioral and work-related risk factors.
until further notice
SourcePain, 126, 1-3, (2006), pp. 72-78
Article / Letter to editor
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Centre for Quality of Care Research
SubjectDCN 1: Perception and Action; DCN 2: Functional Neurogenomics; EBP 1: Determinants of Health and Disease; EBP 4: Quality of Care; N4i 4: Auto-immunity, transplantation and immunotherapy; NCEBP 10: Human Movement & Fatigue; NCEBP 2: Evaluation of complex medical interventions; NCEBP 6:Quality of nursing and allied health care; NCEBP 8: Psychological determinants of chronic illness; UMCN 3.2 Cognitive Neurosciences; UMCN 3.2: Cognitive neurosciences; UMCN 3.3: Neurosensory disorders; EBP 1: Determinants of Health and Disease; NCEBP 10: Human Movement & Fatigue
A significant number of patients who have had surgery for lumbosacral radicular syndrome still have a reduced work capacity several months later. In a prospective cohort study of 182 people who underwent lumbar disc surgery, we determined the predictive value of preoperatively measured cognitive-behavioral and work-related factors on work capacity 6 months after surgery. Logistic regression analyses indicated that these factors independently predicted work capacity 6 months after surgery. Specifically, fear of movement/(re)injury, more passive pain coping, and higher physical work-load predicted reduced work capacity in multiple logistic regression analyses, taking into account the role of a wide range of control variables including demographic variables, preoperative disability and pain intensity, neurological deficits, intake of analgesics, duration of complaints, and pain intensity 3 days postoperatively. The study supports the need to develop and evaluate preoperative risk screening measures that include both cognitive-behavioral and work-related factors and to evaluate the effectiveness of cognitive-behavioral and work-related interventions in patients at risk of reduced work capacity after surgery for LRS.
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