Dean A Tripp1, Edward Abraham2,3,4, Maude Lambert5, Kate Wagg2, Erin Bigney2, Eden Daly2, Phylicia Verreault6, Neil Manson2,3,4. 1. Departments of Psychology, Anesthesiology & Urology, Queen's University, 320 Humphrey Hall, Kingston, ON, K7L 3N6, Canada. dean.tripp@queensu.ca. 2. Canada East Spine Centre, Saint John, NB, Canada. 3. Department of Orthopaedic Surgery, Horizon Health Network, Saint John, NB, Canada. 4. Department of Surgery, Dalhousie School of Medicine, Saint John, NB, Canada. 5. Department of Psychology, University of Ottawa, Ottawa, ON, Canada. 6. Departments of Psychology, Queen's University, Kingston, ON, Canada.
Abstract
PURPOSE: Surgical intervention is a treatment option for various spinal pathology but many patients report no improvement or even an exacerbation of symptoms like pain. This study examined the association of preoperative (pre-op) biopsychosocial risk factors with poor quality of life at 2 and 6 months using hierarchical models controlling demographic and medical variables. METHOD: Participants undergoing thoracolumbar spine surgery (N = 214) were provided with questionnaire packages to complete pre-op, at 2 and at 6-month postoperative clinical follow-ups (i.e., demographics, psychosocial measures, SF-12, medical, and clinical measures). The surgeon recorded surgical measures. RESULTS: Examining the pre-op period only, greater age and medication use (for back symptoms) were associated with poorer physical quality of life [physical component summary score (PCS)], while greater catastrophizing, depression, and lower social support were associated with poorer mental QoL [mental component summary score (MCS)]. Lower preoperative PCS, social support, and greater kinesiophobia were associated with diminished PCS at 2-month. Higher pre-op MCS and higher social support was associated with better MCS at 2-month. Poorer PCS at 6-month was associated with older age and low social support, while diminished MCS was associated with lower pre-op social support, MCS, and longer time in the operation room. Preoperative kinesiophobia partially mediated the relationship between pre-op PCS and 2-month PCS. Age partially mediated the relationship between pre-op PCS and at 6-month. For MCS, social support was the lone partial mediator of baseline MCS and both 2 and 6-month MCS. CONCLUSION: These results show that preoperative psychosocial variables are significantly associated with poorer postoperative health-related QoL outcomes following spinal surgeries, supporting a biopsychosocial pre-op care map.
PURPOSE: Surgical intervention is a treatment option for various spinal pathology but many patients report no improvement or even an exacerbation of symptoms like pain. This study examined the association of preoperative (pre-op) biopsychosocial risk factors with poor quality of life at 2 and 6 months using hierarchical models controlling demographic and medical variables. METHOD:Participants undergoing thoracolumbar spine surgery (N = 214) were provided with questionnaire packages to complete pre-op, at 2 and at 6-month postoperative clinical follow-ups (i.e., demographics, psychosocial measures, SF-12, medical, and clinical measures). The surgeon recorded surgical measures. RESULTS: Examining the pre-op period only, greater age and medication use (for back symptoms) were associated with poorer physical quality of life [physical component summary score (PCS)], while greater catastrophizing, depression, and lower social support were associated with poorer mental QoL [mental component summary score (MCS)]. Lower preoperative PCS, social support, and greater kinesiophobia were associated with diminished PCS at 2-month. Higher pre-op MCS and higher social support was associated with better MCS at 2-month. Poorer PCS at 6-month was associated with older age and low social support, while diminished MCS was associated with lower pre-op social support, MCS, and longer time in the operation room. Preoperative kinesiophobia partially mediated the relationship between pre-op PCS and 2-month PCS. Age partially mediated the relationship between pre-op PCS and at 6-month. For MCS, social support was the lone partial mediator of baseline MCS and both 2 and 6-month MCS. CONCLUSION: These results show that preoperative psychosocial variables are significantly associated with poorer postoperative health-related QoL outcomes following spinal surgeries, supporting a biopsychosocial pre-op care map.
Entities:
Keywords:
Biopsychosocial model; Disability; Quality of life; Spinal surgery
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