Depressive symptoms predict postoperative disability among patients with lumbar spinal stenosis: a two-year prospective study comparing two age groups.
OBJECTIVE
To examine the importance of preoperative and recovery phase depressive symptoms in two age groups of patients with lumbar spinal stenosis (LSS) with respect to surgery outcome 2 years postoperatively.


METHODS
Ninety-six patients with symptomatic LSS underwent decompressive surgery. Data were collected with self-report questionnaires before surgery and 3 months, 6 months, 1 year and 2 years postoperatively. Depression was assessed with the Beck Depression Inventory (BDI). Depressive burden was examined by compiling the sum of preoperative, 3-month and 6-month BDI scores. Physical functioning and pain were assessed with the Oswestry Disability Index, Walking ability and VAS. In the analyses, the subjects were divided into two groups according to the median age (62 years).


RESULTS
Depressive burden was a strong predictor of disability at the 2-year postoperative phase both in younger and elderly patients with LSS. A notable proportion (20%) of the younger patients had considerable depressive symptomatology 2 years after the surgery, whereas in the older age group this proportion was 8%.


CONCLUSIONS
The results suggest that there is a strong relationship between depressive symptoms and disability among postoperative patients with LSS. Identifying and treating patients with preoperative and postoperative depressive symptoms may be a useful strategy for improving LSS surgery outcomes.
Sinikallio
Sanna
S
Department of Rehabilitation (2981), Kuopio University Hospital, Tarinan sairaala, Siilinjärvi, 71800 Finland. sanna.sinikallio@kuh.fi
Aalto
Timo
T
Lehto
Soili M
SM
Airaksinen
Olavi
O
Herno
Arto
A
Kröger
Heikki
H
Viinamäki
Heimo
H
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical / Q000523:psychology / Q000534:rehabilitation; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D013130:Spinal Stenosis / Q000523:psychology* / Q000601:surgery*