RESULTS OF LUMBAR-DISK SURGERY IN A CITY COMPENSATION POPULATION

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.