Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study

Tuomainen, Iina; Pakarinen, Maarit; Aalto, Timo; Sinikallio, Sanna; Kröger, Heikki; Viinamäki, Heimo; Airaksinen, Olavi

doi:10.1016/j.spinee.2017.08.228

Cited by 46 publications

(45 citation statements)

References 41 publications

(53 reference statements)

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“…5 Importantly, the authors noted that while individuals with higher depressive scores demonstrated statistically significant improvement from preoperative ODI scores, observed improvements in VAS and walking distance were not significantly different at 10 years. 5 These results sharply contrast with the significant improvements in all measures observed in the nondepressed cohort in this study. In a review of 67 adults undergoing lumbar discectomy, Chaichana et al noted that individuals with anxiety or depression were significantly less likely to achieve a minimum clinical important difference in disability and quality of life (QOL).…”

Section: Effects Of Psychological Disorders On Postoperative Outcome mentioning

confidence: 94%

“…While this focused research provides a magnitude of knowledge on these 2 disease processes, important gaps in knowledge exist regarding the effects of relatively common psychological diseases, such as schizophrenia and bipolar disorder, on outcomes in spine surgery. Current evidence suggests that patients with psychologic disorders have higher rates of both acute and chronic spine complaints, 3 worse outcomes with treatment, 4 - 6 and more frequent use of narcotic medications. 7 Additionally, those that undergo surgical intervention have higher complication rates than the general population.…”

Section: Introductionmentioning

confidence: 99%

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Correlating Psychological Comorbidities and Outcomes After Spine Surgery

Jackson

Rumley

Griffith

et al. 2019

Global Spine Journal

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Study Design: Literature review. Objective: The aim of this literature review is to examine the effects of psychological disorders on postoperative complications, surgical outcomes, and long-term narcotic use. We also hope to detail the value of preoperative identification and treatment of these pathologies. Methods: A series of systematic reviews of the relevant literature examining the effects of psychological disorders and spine surgery was conducted using PubMed and Cochrane databases. Results: Combined, the database queries yielded 2275 articles for consideration. After applying screening criteria, 96 articles were selected for inclusion. Patients with underlying psychological disease have higher rates of delirium, readmission, longer hospital stays, and higher rates of nonroutine discharge following spine surgery. They also have higher rates of chronic postoperative narcotic use and may experience worse surgical outcomes. Because of these defined issues, researchers have developed multiple screening tools to help identify patients with psychological disorders preoperatively for potential treatment. Treatment of these disorders prior to surgery may significantly improve surgical outcomes. Conclusion: Patients with psychological disorders represent a unique population with respect to their higher rates of spinal pain complaints, postoperative complications, and worsened functional outcomes. However, proper identification and treatment of these conditions prior to surgery may significantly improve many outcome measures in this population. Future investigations in this field should attempt to develop and validate current strategies to identify and treat individuals with psychological disorders before surgery to further improve outcomes.

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Section: Effects Of Psychological Disorders On Postoperative Outcome mentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Correlating Psychological Comorbidities and Outcomes After Spine Surgery

Jackson

Rumley

Griffith

et al. 2019

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…In addition to increasing the risk of PAD, depression also appears to impact the functional status and symptoms of patients with PAD. Depressive symptoms was associated with functional impairment [28] , greater postoperative disability [29] , and higher mortality rates in patients treated with percutaneous coronary intervention [30] .…”

Section: Discussionmentioning

confidence: 99%

Risk factors of depression in type 2 diabetes mellitus with lower extremity arterial disease in China

Chai

Zhang

Yuan

et al. 2020

Preprint

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BackgroundWe aimed to evaluate the prevalence and risk factors of depression in type 2 diabetes mellitus with lower extremity arterial disease. Methods: Four hundred and forty-one patients with type 2 diabetes mellitus were recruited from Peking University of International Hospital. All patients completed the Self-rating Depression Scale, which includes 20 items, using a 4-point scale. Univariable and multivariable logistic regression was conducted to investigate risk factors of depression in patients with lower extremity arterial disease. Results: The prevalence of depression in lower extremity arterial disease group was significantly higher than that in non- lower extremity arterial disease group(25% vs 16%, P = 0.018). In lower extremity arterial disease group(n = 215), depression score(46.18 ± 7.38 vs 44.03 ± 6.53, P = 0.003) significantly increased compared with non lower extremity arterial disease group(n = 226). Compared with male depressive patients, the proportion of female depressive patients(38% vs 15%, P = 0.003) was significantly higher in lower extremity arterial disease group. The depression score of female depressive patients(57.83 ± 3.29 vs 55.26 ± 1.59, P = 0.003) was significantly higher than that of male depressive patients. An increased risk of depression in female patients(crude OR: 2.50, 95% CI: 1.38–4.54, P = 0.003; adjusted OR: 2.34, 95% CI: 1.26–4.36, P = 0.008) and in patients with low body mass index(crude OR: 0.88, 95% CI: 0.80–0.96, P = 0.005; adjusted OR: 0.89, 95% CI: 0.81–0.97, P = 0.011) was detected. Conclusion: Both low body mass index and female are risk factors for depression.

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“…After surgery, patients with moderate psychosocial distress have poorer clinical outcomes, although, in comparison to the preoperative baseline, they improved [13]. In a 10-year follow-up after decompression surgery for lumbar stenosis, Tuomainen et al reported that patients with lumbar stenosis with elevated depressive symptoms had an increased risk of postoperative pain and disability in the long term follow-up than patients without depressive symptoms [14].…”

Section: Introductionmentioning

confidence: 99%

Psychological factors outmatched morphological markers in predicting limitations in activities of daily living and participation in patients with lumbar stenosis

Quack

Boecker

Mueller

et al. 2019

BMC Musculoskelet Disord

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BackgroundRecent demographic changes have led to a large population of older adults, many of whom experience degenerative disc diseases. Degenerative lumbar spinal stenosis (DLSS) is associated with considerable discomfort and limitations in activities of daily living (ADL). Symptomatic DLSS is one of the most frequent indications for spinal surgery. The aim of this study was to identify sociodemographic variables, morphological markers, depression as well as fear of movement that predict ADL performance and participation in social life in patients with DLSS.MethodsSixty-seven patients with DLSS (mean age 62.5 years [11.7], 50.7% females) participated in the study. Predictor variables were age, gender, duration of disease, three morphological markers (severity of the lumbar stenosis, the number of affected segments and presence of spondylolisthesis) as well as self-reported depression and fear of movement. Dependent variables were pain interference with the performance of ADLs, ADLs and participation in social life. Correlations between predictor and dependent variables were calculated before stepwise, linear regression analyses. Only significant correlations were included in the linear regression analyses.ResultsVariance explained by the predictor variables ranged between 12% (R2 = .12; pain interference-physical) and 40% (R2 = .40; ADL requiring lower extremity functioning; participation). Depression and fear of movement were the most powerful predictors for all dependent variables. Among the morphological markers only stenosis severity contributed to the prediction of ADLs requiring lower extremity functioning.ConclusionDepression and fear of movement were more important predictors of the execution of ADLs and participation in social life compared to morphological markers. Elevated depressive symptoms and fear of movement might indicate limited adaptation and coping regarding the disease and its consequences. Early monitoring of these predictors should therefore be conducted in every spine centre. Future studies should investigate whether psychological screening or a preoperative psychological consultation helps to avoid operations and enables better patient outcomes.

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Depression is associated with the long-term outcome of lumbar spinal stenosis surgery: a 10-year follow-up study

Cited by 46 publications

References 41 publications

Correlating Psychological Comorbidities and Outcomes After Spine Surgery

Correlating Psychological Comorbidities and Outcomes After Spine Surgery

Risk factors of depression in type 2 diabetes mellitus with lower extremity arterial disease in China

Psychological factors outmatched morphological markers in predicting limitations in activities of daily living and participation in patients with lumbar stenosis

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