Return to Work Guidelines Following Neurosurgical Procedures.

Gina N Guglielmi,Jason M Seibly

doi:10.7759/cureus.11982

Abstract

Recovery time following surgical procedures is a consideration every practicing surgeon must deliberate upon throughout his or her career. The decision to restrict patients from returning to work or various activities encountered on a daily basis following an operation is dependent on many factors. Surgeons must take into account patient population, individual comorbid conditions, complexity and length of surgery, immediate postoperative course, and baseline functional abilities. Thus, returning to work and various activities, including physical activity, work-related activity, and recreational activity alike, following invasive procedures is individualized from patient to patient. Most spinal procedures are performed by neurosurgeons or orthopedic surgeons. This article suggests a framework to guide appropriate return to work and activity escalation time frames following various spinal procedures.

Highlights

The focus of this paper revolves around the opinions of orthopedic surgeons and neurosurgeons
Each surgeon was asked a series of 10 questions, broken down by specific procedure types: microdiscectomy, one-level lumbar laminectomy, multi-level lumbar laminectomy, one-level anterior cervical discectomy and fusion (ACDF), two-level ACDF, three or more level ACDF, one-level lumbar instrumented fusion, two-level lumbar instrumented fusion, three or more level lumbar instrumented fusion, and posterior cervical foraminotomy
The data are presented based on the average time frame acceptable by participating surgeons for returning to each activity in the postoperative course

Summary

Introduction

The focus of this paper revolves around the opinions of orthopedic surgeons and neurosurgeons. Any surgeon operating on the spine will need to determine when postoperative patients may return to normal activities. The surgeon must weigh the risks of injuring the operative site by allowing too rapid progression of activity following surgery to the benefits of the patient's return to enjoyable recreational activities. If a patient’s activity is increased too abruptly, there is potential for increased pain, muscle spasm/injury, wound dehiscence, recurrent disc herniation, or hardware failure, among other complications. None of these complications has been quantified. To date, there have been no published guidelines in the spinal or neurosurgical literature as to when it is acceptable to return uncomplicated, postoperative patients to various levels of activity

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Discussion

Conclusion