RESULTS OF ELECTIVE LUMBAR DISKECTOMY FOR PATIENTS INVOLVED IN THE WORKERS-COMPENSATION SYSTEM

We compared the outcomes from lumbar discectomy for patients who were workers' compensation claimants and/or who were involved in active lit igation with patients who underwent elective lumbar discectomy, but wh o were not involved with either compensation or litigation. Eighty-two consecutive patients who underwent elective lumbar discectomy by the senior author were identified from 1989 through 1994. Those patients w ho underwent a. primary discectomy with a minimum of 6 months' follow- up were studied. Patients were excluded if a spinal fusion was perform ed or if a multilevel laminectomy procedure was required. Patients wer e classified as compensation patients if they were involved in either worker's compensation claims or active litigation at the time of the l umbar discectomy. The compensation group was further divided into thre e subsets of patients: those involved in active litigation without com pensation, those involved in both compensation and Litigation, and tho se pursuing workers' compensation claims without litigation. The contr ol group was comprised of patients who were not in any way involved wi th compensation or litigation. Outcome assessment and ratings were det ermined independently by the coauthors, not the primary surgeon. Outco me was based on pain, employment status, analgesic use, and level of a ctivity. Fifty-four patients met the inclusion criteria. Average follo w-up for the compensation patients was 40 weeks. Follow-up for the non compensation patients averaged 51 weeks. Eighty-one percent of our pat ients in the noncompensation group achieved a good result. Only 1 of 2 7 patients was categorized as having a poor outcome. Conversely, patie nts who were actively involved in the compensation and/or litigation p rocess had significantly poorer outcomes, with only 29% of the patient s receiving a good outcome evaluation (p = < 0.0002). Legal involvemen t was associated with poorer outcome in compensation patients (p = < 0 .001).