重返工作岗位(RTW)是在职患者的重要手术结局,但仍有相当一部分在职脊髓型颈椎病(CSM)患者接受了颈椎手术,但未能重返工作岗位。在这项研究中,作者调查了在接受颈椎手术、手术结果良好但未能行RTW的CSM人群中与RTW失败相关的因素。
本研究回顾性分析了从国家脊柱登记质量结果数据库的脊髓型颈椎病模块收集的数据。查询质量结果数据库的CSM数据集,以了解手术时工作并计划在术后进行RTW的患者。采用不同的多变量逻辑回归模型拟合3个月的RTW作为整体人群的结果,以确定RTW失败的危险因素。良好的预后定义为无不良事件(再入院或并发症),颈部残疾指数评分改善30%,并且术后3个月满意(北美脊柱协会满意度评分为1或2)的患者。
在409例接受手术的患者中,80% (n = 327)在术后3个月进行了RTW。3个月时,56.9%的患者符合良好手术结果的标准,结果良好的患者更有可能发生RTW (88.1% vs 69.2%, p < 0.01)。在结果良好的患者中,11.9%的患者在3个月时未能进行RTW。尽管结果良好,但未能进行RTW的危险因素包括术前短期残疾或休假状态(or 3.03 [95% CI 1.66-7.90], p = 0.02);较高的颈部残疾指数基线评分(OR 1.41 [95% CI 1.09-1.84], p < 0.01);术后3个月颈部疼痛评分较高(OR 0.81 [95% CI 0.66-0.99], p = 0.04)。
大多数接受脊柱手术的脊髓型颈椎病患者在手术后3个月内重新回到工作岗位,结果良好的患者的RTW率更高。在工作结果良好的患者中,RTW失败与术前短期残疾或术前休假状态以及基线和术后3个月颈部疼痛评分较高有关。
引用时包括2023年2月17日在线发布;DOI: 10.3171 / 2023.1.spine221078。
披露的信息C. Shaffrey博士报告了在提交工作之外从NuVasive、Medtronic、SI Bone和Proprio收取的个人费用。他还报告了以下内容:nuvasive -顾问、版税、股东;Medtronic-consultant版税;SI骨骼顾问,版税;prioprio -顾问,股东。Bisson博士报告了来自Stryker、Medtronic和MiRus的个人费用;她还报告了Proprio和nView的股票期权。王博士报告了在提交的工作之外,DePuy Synthes、Stryker、Spineology、Surgalign和Pacira的个人费用。他还获得了DePuy Synthes的专利,并报告了ISD、kinesiomeics和Medical Device Partners的股票所有权。据奈特利博士报告,他在研究期间担任NPA的主席。 Dr. Virk reported grants from NIH and personal fees from DePuy Synthes outside the submitted work, and stock ownership from OnPoint Surgical. Dr. Turner reported grants and personal fees from ATEC, SeaSpine, and NuVasive outside the submitted work. Dr. Park reported personal fees from Globus, NuVasive, Accelus, DePuy Synthes, and LifeNet; royalties from Globus; lodging and travel for meeting from Medtronic; and grants from Cerapedics, SI Bone, DePuy Synthes, and ISSG outside the submitted work. Dr. Foley reported personal fees from Medtronic outside the submitted work; in addition, he reported multiple patents with royalties paid, issued by Medtronic. He also reported stock ownership in the following: Accelus, Companion Spine, Discgenics, DuraStat, Medtronic, NuVasive, RevBio, and Spine Wave. Dr. Chou reported personal fees from Globus and Orthofix outside the submitted work. Dr. Fu reported personal fees from DePuy outside the submitted work. Dr. Mummaneni reported grants from NREF during the conduct of the study; personal fees from DePuy Synthes, Globus, NuVasive, Stryker, Thieme publishers, and Springer publishers; and grants from AO Spine and NIH outside the submitted work. He also reported stock from Spinicity/ISD. Dr. Than reported personal fees from Bioventus, DePuy Synthes, Accelus, Cerapedics, and SI Bone outside the submitted work.
麦克费登D.分析个人旅行行为的定量方法开云体育世界杯赔率:一些最新进展.474号,考尔斯基金会讨论论文,考尔斯经济学研究基金会,耶鲁大学.1977.2023年1月23日访问.https://EconPapers.repec.org/RePEc:cwl:cwldpp:474
R:用于统计计算的语言和环境.R统计计算基础;2014.2023年1月23日访问。https://www.R-project.org/
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