Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/410
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dc.contributor.authorCunningham, John-
dc.contributor.otherMontgomery, Alexander-
dc.contributor.otherRobertson, Peter-
dc.date2015-
dc.date.accessioned2015-10-07T05:39:50Z-
dc.date.available2015-10-07T05:39:50Z-
dc.date.issued2015-07-
dc.identifier.citationSpine 2015 Jul 15;40(14):1140-7en_US
dc.identifier.issn0362-2436en_US
dc.identifier.issn1528-1159en_US
dc.identifier.urihttp://hdl.handle.net/11434/410-
dc.description.abstractSTUDY DESIGN: Prospective cohort study and systematic literature review. OBJECTIVE: To compare the functional outcomes for lumbar spinal fusion in both compensation and non- compensation patients in an environment of universal no fault compensation and then to compare these outcomes with those in worker's compensation and non-workers compensation cohorts from other countries. SUMMARY OF BACKGROUND DATA: Compensation has an adverse effect on outcomes in spine fusion possibly based on adversarial environment, delayed resolution of claims and care, and increased compensation associated with prolonged disability. It is unclear whether a universal no fault compensation system would provide different outcomes for these patients. New Zealand's Accident Compensation Corporation (ACC) provides universal no fault compensation for personal injury secondary to accident and offers an opportunity to compare results with differing provision of compensation. METHODS: A total of 169 patients undergoing lumbar spinal fusion were assessed preoperatively, at 1 year, and at long-term follow-up out to 14 years, using functional outcome measures and health-related quality-of-life measures. Comparison was made between those covered and not covered by ACC for 3 distinct diagnostic categories. A systematic literature review comparing outcomes in Worker's Compensation and non-Compensation cohorts was also performed. RESULTS: The functional outcomes for both ACC and non-ACC cohorts were similar, with significant and comparable improvements over the first year that were then sustained out to long-term follow-up for both cohorts. At long-term follow-up, the health-related quality-of-life measures were the same between the 2 cohorts. The literature review revealed a marked difference in outcomes between worker's compensation and non-worker's compensation cohorts with a near universal inferior outcome for the compensation group. CONCLUSION: The similarities in outcomes of patients undergoing lumbar spine fusion under New Zealand's universal no fault compensation system, when compared with the dramatically inferior outcomes for these patients under other worker's compensation systems, suggest that the system of compensation has a major influence on patient outcomes, and that change of compensation to a universal no fault system is beneficial for patients undergoing lumbar fusion surgery. LEVEL OF EVIDENCE: 2.en_US
dc.publisherWolters Kluweren_US
dc.subjectMusculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australiaen_US
dc.subjectWorkers' Compensationen_US
dc.subjectResearch Designen_US
dc.subjectScoring Methodsen_US
dc.subjectData Reportingen_US
dc.subjectMatched Groupsen_US
dc.subjectDisability Evaluationen_US
dc.subjectCompensation and Redressen_US
dc.subjectSpinal Fusionen_US
dc.subjectSpondylolisthesisen_US
dc.subjectEmploymenten_US
dc.subjectReturn to Worken_US
dc.subjectInjuriesen_US
dc.subjectSpinal Stenosisen_US
dc.subjectBack Painen_US
dc.subjectQuality of Lifeen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectLiterature Reviewen_US
dc.titleThe influence of no fault compensation on functional outcomes after lumbar spine fusion.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1097/BRS.0000000000000966en_US
dc.identifier.journaltitleSpineen_US
dc.description.pubmedurihttp://www.ncbi.nlm.nih.gov/pubmed/25943088en_US
dc.description.affiliatesSt Bartholomews Hospital, London, Englanden_US
dc.description.affiliatesThe Royal Melbourne Hospital, Parkville, Victoria, Australiaen_US
dc.description.affiliatesDepartment of Orthopaedic Surgery, Auckland City Hospital, Auckland, New Zealanden_US
dc.description.affiliatesThe Royal London Hospital, London, Englanden_US
dc.type.studyortrialProspective Cohort Studyen_US
dc.type.contenttypeTexten_US
Appears in Collections:Musculoskeletal
Neurosciences

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