Literature DB >> 19927107

Depressive burden in the preoperative and early recovery phase predicts poorer surgery outcome among lumbar spinal stenosis patients: a one-year prospective follow-up study.

Sanna Sinikallio1, Timo Aalto, Olavi Airaksinen, Arto Herno, Heikki Kröger, Heimo Viinamäki.   

Abstract

STUDY
DESIGN: Prospective clinical study.
OBJECTIVE: (1) To determine the prevalence of depression at the 1-year postoperative stage among spinal stenosis patients. (2) To assess the predictive value of preoperative and 3-month depressive symptoms regarding the 1-year surgery outcome. SUMMARY OF BACKGROUND DATA: Some studies have found preoperative depressive symptoms to be associated with a poorer spinal stenosis surgery outcome. However, only the effect of preoperative depressiveness has been evaluated. The prevalence of depressiveness on 1-year follow-up among spinal stenosis patients is unclear.
METHODS: One hundred two patients (mean age, 62 years) with symptomatic lumbar spinal stenosis underwent decompressive surgery. They completed the same set of questionnaires before surgery, 3 months, and 1 year after surgery. Depression was assessed with the 21-item Beck Depression Inventory. Physical functioning and pain were assessed with the Oswestry Disability Index, the Stucki Questionnaire, self-reported walking ability, the visual analogue scale and pain drawing. Logistic regression was used to examine the preoperative factors associated with a poorer surgery outcome on 1-year follow-up. In further analysis, a depressive burden variable (sum of preoperative and 3-month Beck Depression Inventory scores) was included as a predictor.
RESULTS: Eighteen percent of spinal stenosis patients were depressed on 1-year follow-up. Higher preoperative Beck Depression Inventory scores and depressive burden scores burden were independently associated with a poorer self-reported functional ability, symptom severity and a poorer walking capacity on 1-year follow-up. As a dichotomous predictor, a high depressive burden was independently associated with all the postoperative outcome variables at the 1-year stage: greater disability, pain and symptom severity, and a poorer walking capacity.
CONCLUSION: The prevalence of depression was notable among 1-year postoperative spinal stenosis patients. Depressive symptoms in the preoperative and early recovery phase were strong predictors of a poorer self-reported surgery outcome on 1-year follow-up. The results call for intervention strategies to detect and treat depression during both the preoperative and postoperative phase.

Entities:  

Mesh:

Year:  2009        PMID: 19927107     DOI: 10.1097/BRS.0b013e3181b317bd

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  17 in total

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9.  Objective measurement of function following lumbar spinal stenosis decompression reveals improved functional capacity with stagnant real-life physical activity.

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