Return To Work And Pain Mgmt Poster

Return to Work and Pain Management after Artificial Disc Replacement vs. Fusion in Single Level Lumbar Disc Disease Rohit Verma MD; Pablo R Pazmino MD, BA; John J. Regan MD Century City Doctors Hospital

Introduction The 2-year IDE data for the CHARITÉ Artificial Disc showed improvements in VAS and ODI for CHARITÉ patients as well as patients fused using a BAK LT cage and BMP. In this study, return to work and use of pain medication was compared between patients undergoing total disc replacement vs. fusion. Results Both groups shared comparable demographics. Using Meyer’s scale, the preoperative medication uses were graded at 4.2±0.9 points for the Fusion group and 4.0±1.6 points for the TDR group, respectively. Post-operatively, these values dropped to 3.6±1.9 points and 1.3±1.7 points for Fusion and TDR (p<0.0001; see Figure 1). In terms of return to work, 69% of the Fusion patients returned to a similar job while 15% were assigned lighter duties. The remaining 16% was not working at 2-year postoperative. These values were comparable in the TDR group, in which 74% maintained similar jobs, 6% were assigned lighter duties and 20% were out of a job at the 2-year time point(Figure 2). Return to work was achieved in 5.1±3.0 months in the Fusion group and 2.5±2.0 months in the TDR group (p=0.0001, Figure 3) Methods Retrospective chart review of 49 patients with total disc replacement (TDR) compared to 26 Fusion patients for single-level lumbar disc degeneration at 2-year post-operative. Return to work (defined as: same job, lighter/part time duty or no job) and use of pain medication was compared in both patient populations. The pain medication was scored using the previously defined Meyer scale.

Conclusions At the 2-year time point, patients in the Fusion group still required more pain medication, based on Meyer’s scale, as compared to patients in the TDR group. In addition, time to return to work was statistically greater in the Fusion vs. the TDR group. Learning Objectives By the conclusion of this session, participants should be able to: 1)realize fusion patients require more pain medication and 2)take longer to return to work then ADR patients

FIGURE 1

Pain medication use per pre and post operative time point. The arrow and p value refer to the difference in post-operative pain medication use between the Fusion and TDR groups.

FIGURE 2

Work status by treatment group at the final postoperative time point. Full time work status was achieved by approximately 70% of patients in both, the Fusion and TDR groups.

FIGURE 3

Return to work in means and medians(months) for both treatment group. Return to work was slower in the Fusion compared to the TDR group, in both means and medians.

FIGURE 1

Pain medication use per pre and post operative time point. The arrow and p value refer to the difference in post -operative pain medication use between the Fusion and TDR groups.

FIGURE 2

Work status by treatment group at the final postoperative time point. Full time work status was achieved by approximately 70% of patients in both, the Fusion and TDR groups.

FIGURE 3

Return to work in means and medians(months) for both treatment group. Return to work was slower in the Fusion compared to the TDR group, in both means and medians.