Surgical issues in the injured worker with lower back pain.

Although most workers who sustain lower back can be managed without surgery, a carefully selected subset of patients benefit from operative intervention. When evaluating these patients, care must be taken to identify surgical emergencies, including patients with cauda equina syndrome and progressive neurologic deficits and patients with cauda equina syndrome and progressive neurologic deficits and patients with certain historical red flags that should prompt further evaluation. Conditions that may benefit from surgery include lumbar disc herniations, discogenic back pain, spinal stenosis, and spondylolisthesis. This article reviews the indications for surgery in injured workers and expected postoperative outcomes.