[Comparative analysis of the professional activity in patients with discopathy of the lumbar spine receiving only conservative therapy or operative therapy].

Unlabelled: Pain syndromes of the lower spine are considered as a serious economical problem throughout the world. They are one of the main reasons of limitation or total disability to work. Social expenses connected with treatment costs are accompanied by deterioration of the patient's financial situation and his family. Evaluation of the professional activity can be a valuable index of treatment efficiency evaluation. The purpose of this study was to comparably evaluate of the professional activity of the patients with lumbar discopathy receiving only conservative treatment as well as operated patients.
Material and Methods: 619 patients aged between 18 and 65 years with discopathy at L4-L5, L5-S 1 levels have been enrolled into the study. In analyzed group 327 patients received only a conservative therapy whereas 292 patients undergone an operative procedure. Evaluation of the degree of the disability to professional activity caused by the disease of the intervertebral disc of the lumbar backbone has been performed based on the following scales: Low-Back Outcome Score (L-BOS) and Functional-Economic Outcome Rating Scale (F-EORS).
Results: Ability to work of the patients receiving conservative therapy was approx. 3.1 (according to F-EORS) what can be defined as ,,work in older profession within limited range". Level of ability to work within subsequent evaluated periods did not tend to change significantly. Ability to hire the operated patients was approx. 2.8 what means "able to work but not in previous profession". In both analyzed groups the highest hiring level (approx. 63%) referred to young patients and it was significantly higher than in patient at the mid age (approx. 47%) and in older patients (approx. 33%).
Conclusions: Disease of the intervertebral disc of the lumbar spine significantly reduced ability to professional work. Hiring ratio shows the strongest correlation with functional status, level of the payment satisfaction and level of the patients' depression. Ratio of return to the professional work is connected with patient's age. Patients at the age below 40 show the highest professional activity. Treatment method does not exert significant influence on the level of the patients' professional activity.