Outcome of Lumbar Fusion in Washington State Workers Compensation

Investigators: Sham Juratli, Gary Franklin, Deb Fulton-Kehoe, Shohail Mirza, Rae Wu, Thomas Wickizer

Over the past few years, the rate of lumbar fusion surgery has increased, possibly due to approval of new technological devices.   We conducted a population-based cohort study of Washington State injured workers covered by the Department of Labor and Industries who underwent lumbar fusion (LF) between January 1994 and December 2001. Our primary outcome measure is work disability status two years after index lumbar fusion.   Secondary outcome measures are the length of work disability in the two years following fusion, reoperation within two years following fusion, time to reoperation and pension status.   We found the following:

  1. Lumbar fusion incidence rate has increased since Sep 1996 following the FDA approval of intervertebral cage devices for treatment of degenerative disc disease.
  2. Use of cage devices has not improved work disability outcomes.
  3. Intervertebral cage device use has not improved the adverse outcome status as measured by postoperative complications and reoperation by 2 years following lumbar fusion.