Life dissatisfaction in the pre-operative and early recovery phase predicts low functional ability and coping among post-operative patients with lumbar spinal stenosis: a 2-year prospective study.
OBJECTIVE
We examined the significance of life dissatisfaction in pre-operative and early recovery phases with respect to functional ability, pain and coping on 2-year follow-up of patients with lumbar spinal stenosis (LSS).


METHODS
Patients (n=90, mean age, 62 years, men 40%) with symptomatic LSS underwent decompressive surgery. Data collection took place with the same set of questionnaires before surgery and 3 months, 6 months and 2 years postoperatively. Life dissatisfaction was assessed with the four-item life satisfaction (LS) scale. In addition, a life dissatisfaction burden, comprising the sum of preoperative, 3-month and 6-month LS scores, was calculated. Physical functioning (Oswestry disability index), pain (VAS and pain drawing) and coping (sense of coherence, SOC) were assessed. Logistic regression analysis was used to examine life dissatisfaction as a predictor of the 2-year functional ability, pain and coping (SOC).


RESULTS
In these analyses, pain was not predicted by either pre-operative life dissatisfaction or life dissatisfaction burden. However, both disability and poor coping on 2-year follow-up were independently associated with both pre-operative and early recovery phase life dissatisfaction.


CONCLUSIONS
Our results show the importance of both pre-operative and early post-operative well-being regarding subsequent functioning. Thus, monitoring of the subjective well-being throughout the pre-operative and post-operative period may indicate those patients at risk of poorer post-operative recovery.
Sinikallio
Sanna
S
Department of Rehabilitation, Kuopio University Hospital, Kuopio, Finland. sanna.sinikallio@kuh.fi
Koivumaa-Honkanen
Heli
H
Aalto
Timo
T
Airaksinen
Olavi
O
Lehto
Soili M
SM
Viinamäki
Heimo
H
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D001294:Attitude to Health; D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013130:Spinal Stenosis / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation* / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome