Effect of social status on occupational reintegration after lumbar discotomy

Abstract

The influence of non somatic factors, especially the social status of the patients' profession on postoperative reintegration following lumbar discectomy is investigated. In 511 patients postoperative loss of working time and time till return-to-work after lumbar discectomy were investigated. Patients were interviewed by questionnaire at an average of 7.6 years postoperatively. Patients returned to work at an average of 10.5 weeks after operation. Looking at the social status of the patients we found an average time of 5.4 weeks until return to full work for self employed people. Civil servants took on average 10.2 weeks and regular employees returned to work after 14.0 weeks. The longest time to return to work was seen in workers with 17.2 weeks. Somatic risk factor profile for nucleus pulposus prolaps was identical in the group of self employed and employees. There was a different risk profile in the other two groups. We could show a correlation between the length of the return-to-work period and long-term clinical outcome with the social status of the patient. This correlation was most clearly shown in the group of self employed and employees. For judgement of the postoperative rehabilitation period, the social status may indicate the pain level and duration of pain that has to be expected.