The outcome of surgery for lumbar disc herniation. II. A 4-17 years' follow-up with emphasis on psychosocial aspects.

We propose that the operated patients without complaints, patients with complaints and pensioned patients with complaints differ in their psychosocial situation. Thus, the first group show the best and the third the worst psychosocial condition. A sample of 135 patients after disc surgery was chosen at random from the patient population (n = 435) responding to a questionnaire. The patients were divided into three groups: no pain (n = 51), pain, no pension (n = 40), pain and a disability pension (n = 44). All have attended a psychosocial screening. They filled in the MMPI and were interviewed on some aspects of their social life, and reported on the coping modes they used in order to subdue their low-back complaints before or after the operation. Independent from the preoperative low-back pain condition and the immediate postoperative results, the operated patients showed, several years after the operation, traceable differences in several psychosocial factors according to the socially and personally defined illness career and its stages. The difference is particularly strong between the patients without complaints and the pensioned patients. The patients with complaints, mainly those receiving a pension, showed more psychopathological features as monitored on MMPI than the patients without complaints. They also reported substantially less satisfactory occupational, family and social life than the patients considered to be complaint-free. Finally, they also differed in their modes of coping with their back problems.