BACKGROUND: Lumbar discectomy is the most frequently performed spinal surgery, and timely return to work is an important marker of functional recovery. Patients with large annular defects are at increased risk of reherniation and reoperation. Bone-anchored annular closure devices have been shown to reduce reherniation rates, but their effect on return to work has not been reported. This study investigates whether treatment with a bone-anchored annular closure device enables faster return to work in high-risk lumbar discectomy patients with large annular defects. METHODS: In this prospective, multicenter, single-arm post-market study, 55 patients with large annular defects undergoing limited lumbar discectomy received a bone-anchored annular closure device. Employment status and return to work were assessed at 4 weeks, 3 months, and 12 months via questionnaires. Preoperative predictors of delayed return to work were analyzed using univariate logistic regression. Patients who were students, retirees, or stay-at-home parents were excluded from return-to-work analyses. Adverse events, reherniation, and reoperation were recorded. RESULTS: = 0.014). Two patients (3.6%) experienced symptomatic reherniation, 1 of whom required reoperation. No device-related adverse events were observed. CONCLUSIONS: Treatment with a bone-anchored annular closure device enabled rapid return to work in high-risk lumbar discectomy patients while maintaining low rates of reherniation and reoperation. CLINICAL RELEVANCE: These findings support the use of bone-anchored annular closure as an adjunct to lumbar discectomy in patients with large annular defects to accelerate return to work.
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Nunley et al. (2026) studied this question.
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