Surgical outcome and postoperative work status of lumbar discogenic pain following transforaminal interbody fusion

Abstract

The clinical outcome and resumption of work were investigated in 21 patients with lumbar discogenic pain (15 males and 6 females, mean age 37.2 years), who failed to respond to intensive conservative therapy, treated by transforaminal lumbar interbody fusion (TLIF) augmented with the pedicle screw system from January 2005 to December 2007. Perioperative assessment was performed using the modified Japanese Orthopaedic Association (mJOA) score, the Oswestry Disability Index, and the visual analogue scale (VAS). Type of occupation and work status of the patients were also assessed before and after surgery. Preoperative occupation was divided into two groups according to the work content (heavy labor vs. light labor). Follow-up period was mean 26.1 months, and greater than 1 year in all patients. Perioperative assessment showed postoperative improvement with statistical significance. Recovery rates at final follow-up examination were 53% of the mJOA score and 65% of the VAS. This study showed that postoperative overall resumption rate was 90%. However, only 23% of the heavy labor group returned to the previous work compared with 71% of the light labor group. TLIF is thought to be a safe and effective technique in patients with intractable chronic lumbar discogenic pain with an acceptable overall work resumption rate, whereas complete return to previous jobs was limited in the heavy labor group.