Neurologic injury had a greater impact on functional outcome than any other variable. Patients limited by pain were more often impaired by residual radicular and neuropathic symptoms than by back pain. Impairment was not related to the extent of either the surgical incision or the instrumentation. Patients with persistent back pain generally had an identifiable and correctable mechanical problem-sagittal imbalance, pseudarthrosis, or persistent instability--as the underlying cause. Our series of trauma patients was predominantly young and male. Among this cohort, individual characteristics of occupation (often physical laborers and craftsmen) and judgment (criminal convictions and incarceration) may have restricted opportunities for re-employment in 40% of the entire study group.
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Trione et al. (1990) studied this question.
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