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Multidisciplinary Clinical Research Center in Musculoskeletal Diseases |
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Disability Outcomes in Intervertebral Disc HerniationThe overall objective of the research is to improve work-related treatment recommendations and outcomes of care for patients with low back pain caused by an intervertebral disc herniation (IDH). Low back problems are a common cause of absence from work and are one of the most frequent reasons for disability compensation claims by working individuals.The financial burden in terms of direct medical costs and lost productivity are immense. In working-age populations, sciatica due to an IDH is a common cause of low-back problems resulting in disability. Surgical treatment is frequently considered for patients with persistent or severe symptoms. More than 250,000 elective lumbar spine operations are performed each year in the United States, with discectomy for an IDH being, by far, the most common procedure. Despite being such a common problem, how medical treatment influences work-related disability is poorly understood in part due to historical separation of health care and disability compensation systems. For the health care system, the goal of back pain treatment is to improve symptoms and function – whether treatment results in quicker return to work or prevents long-term disability is a secondary outcome. For workers with disabling back pain, separate workers’ compensation and private disability insurance are available depending on whether the symptoms are work-related or not, and whether an individual has obtained private disability insurance. Regardless of whether or not the symptoms are attributed to a work-related injury, there is limited information on disability outcomes associated with IDH treatment. Patients receiving workers’ compensation are widely reported to have worse outcomes from back pain though there is little data from controlled studies to support these claims. Even less is known about outcomes of patients with back pain receiving payment through other, private, non-workers’ compensation disability insurers. Using data from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN), we study disability and health-related quality of life outcomes among patients with IDH. IDH patients who are work-eligible (working or would be working if not for their back and/or leg pain) will be classified at baseline according to disability coverage (applying for or receiving workers’ compensation or private disability insurance), and outcomes over time are being examined. |
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