Returning to work and driving after spinal surgery: A web-based survey investigating the opinions of UK spinal surgeons

Abstract

Background/Aims: The UK spinal surgical community has no published recommendations advising when patients can return to driving or to work following spinal surgery. This article aimed to establish the advice given by UK spinal surgeons on these two issues to determine whether specific recommendations can be made. Methods: Members of the British Association of Spinal Surgeons were invited to complete a web-based survey examining the post-operative advice given to patients following: (i) lumbar spine discectomy for radicular leg pain; (ii) single level lumbar spinal fusion for mechanical back pain; (iii) anterior cervical decompression and fusion for radicular arm pain. Results: The opinions of 131 spinal surgeons were obtained, revealing a wide variation in the post-operative advice given. Following lumbar discectomy, an earlier return to driving and work is advised compared with patients who have had lumbar and cervical fusion, with 55% of respondents recommending returning to driving within two weeks. Returning to driving four weeks post-operatively was advised following discectomy, anterior or posterior lumbar fusion, or anterior cervical fusion by 83%, 60% and 68% of respondents, respectively. More than half of respondents recommended returning to work in a light manual capacity after four weeks following discectomy and anterior cervical spine and fusion, and after six weeks following lumbar fusion surgery. Longer time frames were indicated for manual and ‘heavy manual’ workers, with the majority of respondents recommending six to eight weeks following discectomy and 12 weeks following cervical and lumbar fusion surgery. Conclusions: Recommendations on when patients can resume driving and return to work following spinal surgery cannot be definitively made on the basis of this study. Limited evidence suggests that post-operative driving restrictions may not be justified based on driver reaction times and many patients may be safer immediately following surgery than pre-operatively. Advice on returning to work appears justified. This survey may be useful in providing empirical evidence for the post-operative advice for patients undergoing surgical interventions such as lumbar discectomy, posterior lumbar fusion, anterior lumbar interbody fusion, and anterior cervical discectomy and fusion.