Rate of return to military active duty after single level lumbar interbody fusion: a 5-year retrospective review

Neurosurgery. 2012 Aug;71(2):317-24; discussion 324. doi: 10.1227/NEU.0b013e318258e1da.

Abstract

Background: Lumbar interbody fusion has been extensively studied in the civilian population; however, data regarding its efficacy in the military are lacking.

Objective: To identify the rate of return to unrestricted active military duty after single-level lumbar interbody fusion surgery.

Methods: The surgical database at a single tertiary care military treatment facility was queried for active-duty patients who underwent a single-level lumbar interbody fusion over a 5-year period. A retrospective chart review was performed with backward stepwise logistic regression analysis, and Fisher exact and Wilcoxon rank sum tests were used for statistical analysis.

Results: A total of 102 patients met the inclusion criteria. Mean age at surgery was 34.0 years (range, 19-51 years). Most surgeries (59%) were performed for discogenic pain secondary to degenerative disc disease; the remaining patients underwent surgery for spondylolisthesis (39%) or spinal stenosis (2%). Thirty-nine patients (38%) were treated via an anterior approach (anterior lumbar interbody fusion), whereas 63 patients (62%) underwent fusion via a posterior approach (transforaminal or posterior lumbar interbody fusion). Fifty-six patients (55%) were able to return to unrestricted full active duty, and the remaining 46 patients (45%) were separated from the military. The return to active duty rate was significantly higher in older patients and those ranking E7 (Chief Petty Officer) and above (84.8%).

Conclusion: Fifty-five percent of the service members who underwent a single-level lumbar interbody fusion returned to unrestricted full duty. Older age and higher rank were statistically significant positive predictors of a successful return to active duty.

MeSH terms

  • Adult
  • Comorbidity
  • Employment / statistics & numerical data*
  • Humans
  • Low Back Pain / epidemiology
  • Low Back Pain / prevention & control
  • Lumbar Vertebrae / surgery*
  • Male
  • Middle Aged
  • Military Personnel / statistics & numerical data*
  • Prevalence
  • Recovery of Function
  • Retrospective Studies
  • Risk Factors
  • Spinal Diseases / epidemiology*
  • Spinal Diseases / surgery*
  • Spinal Fusion / statistics & numerical data*
  • Treatment Outcome
  • United States / epidemiology