Why are Lumbar Spinal Fusion (LSF) surgery outcomes for workers’ compensation patients worse than for the general population? ISCRR’s Research Lead, Dr Janine McMillan, set out to answer this question in a recently published paper in the ANZ Journal of Surgery: “Lumbar spinal fusion surgery outcomes in a cohort of injured workers in the Victorian workers’ compensation system”.

LSF is designed to stop movement in the lower back, at a painful vertebral segment. The aim of the surgery is to decrease the pain generated from the joint.

Study objectives:

  • To examine the long-term work capacity, opioid prescription and mental health outcomes of injured workers who have undergone LSF surgery in Victoria, Australia.
  • To identify demographic and pre- and post-operative characteristics associated with these outcomes.

The study found that two years after LSF surgery, only 32% of the injured workers had substantial work capacity, but 44% were prescribed opioids, and 38% were receiving mental health treatment.

Having an existing opioid prescription and a limited work capacity before surgery were independent strong predictors of whether a patient would be prescribed opioids, have a reduced work capacity and require mental health treatment two years after LSF.

Such pre-operative factors are associated with post-operative outcomes after LSF in this Victorian workers’ compensation population. This means that a patient’s pre-operative status may influence surgery outcomes and should be considered in LSF decisions.

The high opioid use of patients indicated that opioid management before and after surgery needs urgent review.


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