Rates of Employment and Return to Work After Spinal Cord Lesion Onset in Israel.

The included patients were younger, more often male, more educated, and had higher function scores than the 1,670 excluded patients, which may bias results toward better outcomes. Employment was defined as any paid work at any time after onset, without accounting for duration, hours, or job quality, potentially overestimating stable vocational integration. The study did not collect data on vocational rehabilitation participation, workplace accommodations, or specific job types, limiting the ability to assess intervention effects. Missing data occurred for less than 18% of variables, but the reliance on retrospective chart review and phone interviews may introduce recall bias. The study was conducted in Israel, where disability employment policies and cultural factors differ from other countries, limiting generalizability to other settings.

The investigators declared no financial or nonfinancial conflicts of interest.

Do not assume that spinal cord injury level or AIS severity determines employment prospects. This study found no independent association between injury level or severity and employment; instead, pre-injury employment, education, and functional independence were the significant predictors.