Can psychological traits predict the outcome of lumbar disc surgery when anamnestic and physiological risk factors are controlled for? Results of a prospective cohort study

Graver, Vibeke; Ljunggren, Anne Elisabeth; Malt, Ulrik Fredrik; Loeb, Mitchell; Haaland, Alf Kristian; Magnæs, B.; Lie, Hanne C.

doi:10.1016/0022-3999(94)00148-x

Cited by 42 publications

(31 citation statements)

References 34 publications

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“…7,23,27 Forty-eight hours after surgery, anxiety was, again, predictive of PPSP. Surprisingly, never before was anxiety after surgery studied as a potential predictor for PPSP.…”

Section: Demographic and Clinical Baseline Predictorsmentioning

confidence: 95%

Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

Pinto

McIntyre

Nogueira‐Silva

et al. 2012

The Journal of Pain

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Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual, social, and healthcare costs. The aim of this study was to examine the role of demographic, clinical, and psychological risk factors in the development of PPSP after hysterectomy due to benign disorders. In a prospective study, a consecutive sample of 186 women was assessed 24 hours before surgery (T1), 48 hours after surgery (T2), and 4 months after surgery (T3). Regression analyses were performed to identify predictors of PPSP. Four months after hysterectomy, 93 (50%) participants reported experiencing pain (numerical rating scale >0). Age, pain due to other causes, and type of hysterectomy emerged as significant predictive factors. Baseline presurgical psychological predictors identified were anxiety, emotional illness representation of the condition leading to surgery, and pain catastrophizing. Among the identified psychological predictors, emotional illness representation emerged as the strongest. Acute postsurgical pain frequency and postsurgical anxiety also revealed a predictive role in PPSP development. These results increase the knowledge on PPSP predictors and point healthcare professionals toward specific intervention targets such as anxiety (presurgical and postsurgical), pain catastrophizing, emotional illness representations, and acute pain control after surgery.Perspective: This study found that presurgical anxiety, emotional illness representations, and pain catastrophizing are risk factors for PPSP 4 months after hysterectomy, over and above age and clinical variables. These findings improve knowledge on PPSP and highlight potential intervention targets for healthcare professionals.

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“…7,23,27 Forty-eight hours after surgery, anxiety was, again, predictive of PPSP. Surprisingly, never before was anxiety after surgery studied as a potential predictor for PPSP.…”

Section: Demographic and Clinical Baseline Predictorsmentioning

confidence: 95%

Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

Pinto

McIntyre

Nogueira‐Silva

et al. 2012

The Journal of Pain

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“…Previous studies of coping behaviors and surgical outcome have not been successful at demonstrating an association between active coping and physical recovery (Gross, 1986;Graver et al, 1995;deGroot et al, 1997). However, unlike previous studies, the present study included both preoperative and postoperative functional status in the analysis of the relationship.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, patients were less likely to perform such actions as using stairs, and were slower in timed walking tests. In contrast, three studies investigating recovery from back surgery found no relationship between preoperatively assessed coping behaviors and physical outcome, including physical complaints (e.g., headache, nausea) three days following surgery (deGroot et al, 1997); pain and clinical ratings (e.g., walking on hospital ward, general activity level) five days and six weeks postsurgery (Gross, 1986); and, back pain, leg pain, function, and analgesic use one year postsurgery (Graver et al, 1995).…”

Section: Introductionmentioning

confidence: 99%

Physical recovery in Arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity

Rosenberger

Ickovics

Epel

et al. 2004

Psychology & Health

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Few studies have examined whether certain coping behaviors are associated with physical outcomes following surgery. This prospective, longitudinal study investigated the effect of active and avoidant coping behaviors on two physical outcomes over time, pain and knee function, in a group of patients experiencing knee arthroscopic surgery (n ¼ 81). Structured interviews and physician clinical assessments were conducted preoperatively and at 3 and 24 weeks postoperatively. Coping behavior was assessed during the preoperative interview, and patients were divided into high and low avoidant and active coping groups. Using repeated measures MANCOVA/ANCOVA, avoidant coping was significantly associated with knee pain and active coping was associated with knee function. Serum cortisol levels were available for a patient subset (n ¼ 16); higher cortisol was related to both avoidant coping and poorer functioning during early recovery. Results suggest that these divergent coping behaviors are differentially associated with stress reactivity and physical outcomes in healthy patients undergoing minor knee surgery.

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“…This study was part of a more extensive investigation of prognostic factors of the outcome of lumbar disc surgery [11,13]. The pre-operative inclusion criteria were clinical symptoms and corresponding neuroradiological findings of nerve root compression due to lumbar disc herniation, with no, or little associated degenerative changes, and age below 70 years.…”

Section: Methodsmentioning

confidence: 99%

Is the outcome of traditional lumbar disc surgery related to the size of the exposure?

Graver

Ljunggren²,

Magnæs

et al. 1996

Acta neurochir

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The purpose of this study was to evaluate whether wide surgical exposures result in poorer outcome of lumbar disc surgery compared to smaller traditional exposures. The aim was also to assess if a dural tear has any impact on the postoperative clinical outcome. One hundred and twenty-two patients (56 women and 66 men, mean age 40.8 years) with herniated intervertebral lumbar disc and no previous back surgery, were included. Postoperatively they were grouped according to surgery as follows: surgery on one vs. two herniated discs (106 vs. 16 patients), partial vs. full laminectomy (93 vs. 29 patients), and the occurrence or not of a dural rent (8 vs. 114 patients). The outcome of surgery was evaluated one years postoperatively mainly by a composite clinical overall score (COS) and by its separate elements, which were: pain intensity in the lower-back or leg (VAS), neurological and clinical examination, functional capacity (Oswestry), and the need for analgesics. The results of the statistical regression analyses did not reveal significant differences in the postoperative outcome scores in the various groups of patients. The groups were comparable; no significant differences were seen in the pre-operative clinical overall scores.

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Can psychological traits predict the outcome of lumbar disc surgery when anamnestic and physiological risk factors are controlled for? Results of a prospective cohort study

Cited by 42 publications

References 34 publications

Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

Risk Factors for Persistent Postsurgical Pain in Women Undergoing Hysterectomy Due to Benign Causes: A Prospective Predictive Study

Physical recovery in Arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity

Is the outcome of traditional lumbar disc surgery related to the size of the exposure?

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