Return to Work After Surgery for Cervical Radiculopathy: Prospective Data From a Swedish Nationwide Cohort of 3929 Patients

BACKGROUND AND OBJECTIVES: Surgical decompression is commonly required to relieve symptoms of cervical radiculopathy and allow for functional recovery. There are only a handful of studies analyzing return-to-work (RTW) outcomes after cervical spine surgery for cervical radiculopathy. This study seeks to elucidate RTW outcomes and to identify predictors preventing RTW in patients surgically treated for cervical radiculopathy in a Swedish nationwide prospective registry. METHODS: A nationwide cohort analysis was conducted using prospectively gathered data from the Swedish Spine Registry. All patients with documented postoperative outcomes focusing on 1-year RTW rates were included. To identify predictive factors influencing RTW at 1 year postoperatively, separate univariable and multivariable logistic regression models were developed, incorporating demographic, functional and clinical, as well as preoperative and postoperative data, and occupational characteristics. RESULTS: A total of 3929 patients were included with an average age of 49.5 years, with most patients working in moderate- or high-intensity jobs and nearly half on sick leave before surgery. Most surgeries were elective, and an anterior approach was preferred. At the 1-year mark after surgery, 85% of patients had returned to work, with full-time RTW reaching 67% and part-time RTW 18%. In this cohort, 15% had not returned to work at all. Higher age, previous cervical spine surgery, high job intensity, preoperative full-time sick leave and full-time sickness benefits, longer preoperative arm pain durations as well as higher preoperative Neck Disability Index, and lower EuroQOL 5 dimensions scores were independently associated with a reduced likelihood of RTW at 1 year postoperatively. CONCLUSION: Eighty-five percent of the patients surgically treated for radiculopathy RTW within 1 year. Higher age, jobs with greater physical demands, longer duration of arm pain, higher preoperative neck disability index and lower EuroQOL 5 dimensions scores, as well as being on full-time sick leave, were all linked to a reduced chance of RTW.