P125. Rates and predictors of return to work after surgery for cervical spondylotic myelopathy: analysis from the Canadian Spine Outcomes and Research Network (CSORN)

Abstract

BACKGROUND CONTEXT Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction internationally; however, few studies have evaluated return to work (RTW) after CSM surgery. PURPOSE Our goals were to determine rates and predictors of postoperative RTW and to compare postoperative rates to a lumbar spondylolisthesis cohort. STUDY DESIGN/SETTING Retrospective review of prospectively-collected data. PATIENT SAMPLE Non-retired patients undergoing surgical decompression for CSM. OUTCOME MEASURES Return to work (ie, active employment) at 1-year following surgery. METHODS Data were derived from the CSORN prospective, multi-center surgical CSM registry. From this cohort, we included all non-retired patients with at least 1-year follow-up. RTW rate was defined as the proportion of patients with active employment at 1-year from the time of surgery. Bivariable and multivariable logistic regression were used to identify patient, disease and treatment variables predicting RTW. RESULTS Of 211 surgically treated CSM patients with 1-year follow-up, 102 (48.3%) were considered non-retired preoperatively, with 54.5% working and 45.5% not working in the immediate period before surgery. At 1-year, 60 patients (58.8%) had returned to work, while 42 (41.2%) were not working. In bivariable analyses, while working preoperatively predicted postoperative RTW(p 0.05). In multivariable analyses, only preoperative employment status predicted RTW, with those working pre-op having 12 times greater odds of working at 12 months postoperative (OR:12.1,95%CI:2.2,66.5). For comparison, the 1-year post-surgical RTW rate in the CSORN lumbar spondylolisthesis study cohort was 70.0%. CONCLUSIONS The majority (58.8%) of non-retired patients undergoing surgery for CSM had returned to work 12 months postoperative; preoperative work status was the only significant predictor of RTW in this analysis. RTW rates appear to be lower in CSM compared to lumbar spondylolisthesis. These results will help to inform preoperative patient counseling, enable economic analyses and serve as a focus for future quality improvement efforts. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.