Role of trait anxiety in persistent radicular pain after surgery for lumbar disc herniation: a 1-year longitudinal study.
OBJECTIVE
To evaluate anxiety and depression as prognostic factors for radicular and back pain after surgery in patients with lumbar disc herniation in a 1-year follow-up study.


METHODS
A total of 108 patients with lumbar disc herniation were enrolled in the study. Anxiety was assessed by State and Trait Anxiety Inventory; current depression was assessed by Zung Self-Rating Depression Scale. Severity of pain was scored on the visual analog scale (VAS). The State and Trait Anxiety Inventory, Zung Self-Rating Depression Scale, and VAS were administered before surgery and 1, 3, 6, and 12 months after surgery.


RESULTS
Before surgery, 72.2% of patients showed state anxiety, 54.6% of patients showed trait anxiety, and 11.1% of patients showed current depression. During the follow-up period, there was a significant decrease in the prevalence of state anxiety (P < .0001), no variation in the prevalence of trait anxiety (P = .115), and a significant increase in the prevalence of current depression (P = .002). Linear regression analysis showed that the presence of trait anxiety before surgery was the main determinant of the presence of pain after surgery (P < .0001). VAS scores were evaluated by dividing patients into 2 groups based on the presence or absence of trait anxiety before surgery. The subgroup affected by trait anxiety before surgery had significantly higher VAS scores at each follow-up assessment compared with patients without trait anxiety (P < .0001).


CONCLUSIONS
The presence of trait anxiety before surgery is a prognostic factor for the persistence of pain after surgery.
D'Angelo
Cristina
C
Institute of Internal Medicine, Catholic University of Rome, Rome, Italy. g.addolorato@rm.unicatt.it
Mirijello
Antonio
A
Ferrulli
Anna
A
Leggio
Lorenzo
L
Berardi
Arturo
A
Icolaro
Nadia
N
Miceli
Antonio
A
D'Angelo
Vincenzo
V
Gasbarrini
Giovanni
G
Addolorato
Giovanni
G
D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000523:psychology; D004651:Employment; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000601:surgery; D008161:Lumbosacral Region / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology; D009483:Neuropsychological Tests; D010147:Pain Measurement; D010149:Postoperative Pain / Q000523:psychology*; D011379:Prognosis; D012737:Sex Factors; D012959:Socioeconomic Factors; D014937:Work