Timelines and Associated Factors for Return-to-Work of Patients With Painful Lumbar Radiculopathy Who Undergo Lumbar Microdiscectomy Followed by Physiotherapy: A Prospective Cohort Study.

STUDY

DESIGN

Prospective cohort study with a 52 weeks follow-up.

OBJECTIVE

Medical absenteeism in patients with painful lumbar radiculopathy undergoing lumbar microdiscectomy followed by physiotherapy is associated with high socioeconomic costs. We lack good quality information about the time to return-to-work and the factors associated with returning-to-work in this patient group. The objective of this study is to describe the probability of return-to-work and explore associations between routinely collected preoperative factors and return-to-work for patients with painful lumbar radiculopathy undergoing lumbar microdiscectomy and postoperative physiotherapy.

MATERIALS AND

METHODS

We included 257 patients with clinical signs and symptoms of painful lumbar radiculopathy in whom nerve root compression was confirmed by magnetic resonance imaging, and who underwent microdiscectomy and postoperative physiotherapy. Time to return-to-work was evaluated using Kaplan-Meier survival analysis. The association between independent factors and return-to-work was examined through Cox regression analysis.

RESULTS

Full resumption of their original paid job ( i.e. same role with the same physical demands and responsibilities) occurred in 178 (69.3%) of participants by 52 weeks. In these patients, the median (IQR) return-to-work time was 16 weeks (14-16), with 85.0% of patients resuming work within 26 weeks. Higher education (HR=1.82), self-employment (HR=1.84), and the absence of predominant physical work (HR=1.61) were significantly associated with a faster return-to-work, while higher disability scores negatively impacted return-to-work time (HR=0.56).

CONCLUSION

At 52 weeks following lumbar microdiscectomy and postoperative physiotherapy for painful lumbar radiculopathy, approximately two-thirds of individuals returned to work in their original roles, while some transitioned to different roles. Work-related and personal factors play a key role in determining the timing of this return. Recognizing these predictors in clinical practice can help surgeons, physiotherapists, and occupational health professionals guide patient expectations, provide more individualized workplace counselling, and support realistic, timely, and sustainable work reintegration.