A 5-year follow-up study
Maarit Pakarinen, MD
The Spine Journal
Available online 30 January 2014
Abstract
Background context
In lumbar spinal stenosis (LSS) conservative treatment is usually the first choice of treatment. If conservative treatment fails, surgery is indicated. Psychological factors such as depression and anxiety are known to affect the outcome of surgery. Previous studies on depression and surgery outcome using long follow-up times are scarce.
Purpose
The purpose of this study was to investigate the effect of depressive symptoms on the surgical outcome during a 5-year follow-up among patients with lumbar spinal stenosis.
Study Design
A prospective observational study.
Patient sample
Patient sample included 102 LSS-patients who needed surgical treatment.
Outcome Measures
The outcome of surgery was evaluated with the Oswestry Disability Index, VAS pain assessment and self-reported walking capacity.
Methods
The patients completed a set of questionnaires preoperatively and 3 and 6 months, and 1, 2 and 5 years after the surgery. Depressive symptoms were assessed with the Beck Depression Inventory. The depressive burden was estimated by summing all individual BDI scores. Statistical analyses included cross-sectional group comparisons and linear regression analyses. No conflicts of interest.
Results
On 5-year follow-up, a high depressive burden associated with a poorer outcome of surgery when assessed with the Oswestry Disability Index. In linear regression analysis, a high depressive burden associated with higher Oswestry Disability Index score.
Conclusions
Even slightly elevated long-term depressive symptoms in LSS-patients are associated with an increased risk of a poorer functional ability following decompressive surgery.