Functional Capacity Evaluation Following Spinal Fusion Surgery
Bibliographic record
Abstract
STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: The aim of the study was to characterize outcomes of functional capacity evaluations (FCEs) amongst patients undergoing spinal fusion surgery. SUMMARY OF BACKGROUND DATA: Injured workers often undergo an FCE upon reaching maximal medical improvement following surgery. To date, few studies have examined the results of FCEs following spinal fusion. METHODS: Patients undergoing an FCE following a minimally invasive transforaminal lumbar interbody fusion (TLIF) or anterior cervical discectomy and fusion (ACDF) were retrospectively identified. Based upon the FCE report, each patient's job-related preoperative physical requirement and postoperative work capability was categorized as light, medium, or heavy. Patients were characterized as being able to meet their preoperative job requirement if their FCE-determined capability was greater than or equal to their preoperative job requirement. Patient characteristics were tested for association with meeting preoperative job requirement using bivariate and multivariate regression. RESULTS: A total of 173 patients were identified: 71 (41.0%) and 102 (59.0%) underwent TLIF and ACDF, respectively. Of the 71 TLIF and 102 ACDF patients, 41 (58%) and 50 (49%) had light postoperative capabilities, 18 (25%) and 38 (37%) as medium, and 12 (17%) and 14 (14%) as heavy, respectively. Postoperatively, 26 (37%) of TLIF and 55 (54%) of ACDF patients were categorized as meeting their preoperative job requirement. Independent predictors of meeting preoperative job requirement following TLIF (P =0.002) and ACDF (P = 0.037) were lower preoperative job requirement, and younger age for ACDF (P < 0.001). CONCLUSION: Only one in five patients undergoing spinal fusion surgery for occupational injuries is able to perform heavy-duty work postoperatively. Similarly, approximately half of patients are able to perform medium-duty work. Moreover, a majority of patients are unable to return to their preoperative occupational responsibilities. These findings can be used to council patients regarding their likelihood of meeting postoperative work capacity. LEVEL OF EVIDENCE: 3.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".