This is a retrospective analysis of 118 patients who underwent 132 ope
rations in a city compensation setting for the treatment of lumbar dis
k disease from January 1976 to December 1987. Each of these patients h
ad a work-related injury. There was a minimum 2-year follow up with an
average follow up of 6.9 years. No patients were lost to follow up Th
e purpose was to determine what percentage of patients treated in a wo
rk-related setting could be expected to return to a sustained, pre-inj
ury employment state following a carefully executed lumbar spine surgi
cal procedure. Satisfactory surgical results were considered achieved
only by those patients who returned to full-duty work status. Only 31
of the 118 patients (26%) returned to full duty and were considered sa
tisfactory. Regarding the number of surgical procedures, 31 of 132 ope
rations (23%) were successful. Sixteen reoperations in 13 patients all
resulted in failure. Only 16 of the 64 patients (25%) treated with la
minectomy and diskectomy alone had a satisfactory result. When a two-l
evel, posterior lateral spinal fusion was added the success rate was i
ncreased to 44%, with 12 of 27 patients returning to work. Six patient
s with spinal stenosis underwent decompression laminectomy and entry l
evel foraminotomies, and all had unsatisfactory results. Five patients
with isthmic spondylisthesis underwent a Gill procedure and fusion. O
nly one of these patients (25%) returned to work. For a 2-year period
chymopapain injection was given to 14 patients. Only two returned to w
ork, with a 14% success rate. Overall, the surgical treatment of lumba
r disk disease in this group of city compensation patients resulted in
a 74% rate of permanent disability.