Depression is associated with poorer outcome of lumbar spinal stenosis surgery

The objective of this observational prospective study was to investigate the effect of depression on short-term outcome after lumbar spinal stenosis (LSS) surgery. Surgery was performed on 99 patients with clinically and radiologically defined LSS, representing ordinary LSS patients treated at the s...

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Bibliographic Details
Published in:European spine journal 2007-07, Vol.16 (7), p.905-912
Main Authors: Sinikallio, Sanna, Aalto, Timo, Airaksinen, Olavi, Herno, Arto, Kröger, Heikki, Savolainen, Sakari, Turunen, Veli, Viinamäki, Heimo
Format: Article
Language:English
Subjects:
Depression - psychology
Female
Humans
Lumbar Vertebrae - pathology
Lumbar Vertebrae - surgery
Male
Mental depression
Middle Aged
Original
Orthopedic Procedures - psychology
Pain
Patients
Recovery of Function
Spinal stenosis
Spinal Stenosis - psychology
Spinal Stenosis - surgery
Surgery
Surveys and Questionnaires
Treatment Outcome
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Summary:The objective of this observational prospective study was to investigate the effect of depression on short-term outcome after lumbar spinal stenosis (LSS) surgery. Surgery was performed on 99 patients with clinically and radiologically defined LSS, representing ordinary LSS patients treated at the secondary care level. They completed questionnaires before surgery and 3 months postoperatively. Depression was assessed with the 21-item Beck Depression Inventory (BDI). Physical functioning and pain were assessed with Oswestry disability index, Stucki Questionnaire, self-reported walking ability, visual analogue scale (VAS) and pain drawing. Preoperatively, 20% of the patients had depression. In logistic regression analyses, significant associations were seen between preoperative depression and postoperative high Oswestry disability and Stucki severity scores and high intensity of pain (VAS score). In subsequent analyses, the patients with continuous depression, measured with BDI (60% of the patients who had preoperative depression), showed fewer improvements in symptom severity, disability score, pain intensity and walking capacity than the patients who did not experience depression at any phase. In those patients who recovered from depression, according to BDI-scores (35% of the patients with preoperative depression), the postoperative improvement was rather similar to the improvement seen in the normal mood group. In the surgical treatment of LSS, we recommend that the clinical practice should include an assessment of depression.
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-007-0349-3