Musculoskeletal diseases often have concomitant psychological disorders, such as depression and anxiety. Frozen shoulder (FS) is a musculoskeletal disease, and causes pain and stiffness in the shoulder. The relationship between FS and psychological disorders has rarely been investigated. This cross-sectional study was to evaluate the risk of depression and anxiety in patients with primary FS, and to explore the relationship between psychological disorders and disease status. In this study, anxiety and depression were evaluated in 124 patients (78 women and 46 men) with primary FS, compared with 130 (72 women and 58 men) age-, sex- and education matched healthy controls between March 2009 and June 2012. Simple shoulder test (SST); shoulder pain and disability index (SPADI); the range of motion (ROM); visual analog scales (VAS) for pain and sleep disturbances; hospital anxiety and depression scale for depression (HADS-D) and for anxiety (HADS-A); and health assessment questionnaire (HAQ) were used to assess clinical and psychological status. In FS patients, the prevalence of depression and anxiety was 28.2 and 24.2%, respectively. Compared with the healthy controls, higher HADS-D (6.41 ± 3.69, 5. 23 ± 2.87 p = 0.006) and HADS-A (6.16 ± 3.62, 4.90 ± 3.05 p = 0.003) were detected. The FS patients with depression or anxiety had significantly lower SST and HAQ scores, significantly higher VAS and SPADI scores and significantly higher prevalence of sleep disturbances compared with the FS patients with normal psychological status. The correlations of SST, SPADI, VAS and sleep disturbances but not ROM with HADS-A and HADS-D were significant ( p < 0.05). This finding indicates that anxiety and depression may coexist with FS; patients with psychological disorders have more severe self-reported shoulder pain and functional restriction.
Posterior decompression surgery was performed on 610 patients (mean age 62 years) with clinically and radiologically defined cervical spondylotic myelopathy (CSM) at Tianjin Medical University General Hospital, between October 2007 and October 2011. After 2-year follow-up, we had a full data sets from 396 patients with normal mood or continued depression during the whole process to be compared. Depression was assessed with the 21-item Beck Depression Inventory. Physical functioning and pain were assessed with the modified Japanese Orthopedic Association (mJOA) scoring system, neck disability index (NDI), and visual analog scale (VAS). There were statistically significant differences from baseline to 2-year follow-up between normal mood (n = 258) and continuous depression (n = 138) groups in mJOA score (6.76 ± 3.12 vs. 1.42 ± 0.56, respectively; p < 0.01), VAS (23.85 ± 20.79 vs. 16.08 ± 19.76, respectively; p < 0.01), and NDI (21.11 ± 11.36 vs. 7.31 ± 2.18; p < 0.05). The adverse consequences of depression are supported by previous findings that patients with depression suffer more unsatisfactory surgery outcome than the patients with normal mood. We emphasize that patients with continuous depression show poorer improvement after posterior decompression in CSM patients with respect to symptom severity, pain intensity, and the disability score than patients without depression at any stage.
POT is a spinal cord-free pathway between OLF bloc and its neighboring pedicles in thoracic spinal stenosis which can be applied in neuron preserved decompression surgery.
Depression is associated with a higher risk of thoracolumbar fracture, with more fracture pain and with lower quality of life in the 2 months following fracture.
A series of clinical results were obtained after the extensive laminectomy for a long-term follow-up period exceeding 10 years. The extensive laminectomy may be an option for an alternative procedure for treatment of MCS with LFH.
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