Employment outcomes following thoracic and lumbar fractures in Wales: Long term follow up greater than 5 years.

Abstract

Retrospective study. To identify outcomes, in particular employment, >5 years following traumatic thoracic and/or lumbar fracture/s. 235 patients between the ages of 18 and 65 were identified from hospital radiology databases having sustained a traumatic thoracic and/or lumbar fracture on CT and/or MRI between 01/01/2013 and 31/12/2017. Questionnaires were sent via post and available emails, with a reminder letter and phone calls. Retrospective data was gathered about employment status pre-fracture and > 5 years post-injury. 26 (11 %) patients died before follow-up, leaving 209 patients. 108 (52 %) were treated surgically and 101 (48 %) conservatively. 106 replies were received, with 85 (80 %) opting in and 21 (20 %) out. 68 (80 %) patients completed full questionnaires, and 17 (20 %) filled out a shortened questionnaire via phone conversation. Of the 85 enrolled patients, 52 (61 %) had undergone surgery, and 33 (39 %) had been treated conservatively. The mean follow-up time was 7.9 years (range 5-11 years). Prior to injury, 66 patients (78 %) were employed and 19 (22 %) unemployed (6 were full-time students, 8 retired). 49 (74 %) previously employed patients had returned to work at follow-up, with 35 (53 %) working the same or increased hours. Regarding employment, there was no significant difference between the treatment groups (p = 0.355) or the fracture classification (p = 0.303). 16 (19 %) patients reported back pain before their injury, whilst 69 (81 %) did not. There were 58 (68 %) cases of new pain, with the most affected area being the lumbar region in 43 (51 %) patients. 32 (38 %) patients reported neurological deficit post-injury: 19 with subjective symptoms, 9 objective symptoms and 4 suffered paralysis. After 5 years or more following a traumatic thoracic and/or lumbar fracture, most individuals return to employment. There was no significant difference between the severity of the fracture or treatment on their employment outcomes.