Depressive burden is associated with a poorer surgical outcome among lumbar spinal stenosis patients: a 5-year follow-up study.
BACKGROUND
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.


OBJECTIVE
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 LSS.


METHODS
A prospective observational study.


METHODS
Patient sample included 102 LSS patients who needed surgical treatment.


METHODS
The outcome of surgery was evaluated with the Oswestry Disability Index (ODI), visual analog scale pain assessment, and self-reported walking capacity.


METHODS
The patients completed a set of questionnaires preoperatively and 3 and 6 months, as well as 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 Beck Depression Inventory 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 ODI. In linear regression analysis, a high depressive burden associated with higher ODI score.


CONCLUSIONS
Even slightly elevated long-term depressive symptoms in LSS patients are associated with an increased risk of a poorer functional ability after decompressive surgery.
Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland. Electronic address: maarit.pakarinen@kuh.fi.
Maarit
M
Pakarinen
Department of Physical and Rehabilitation Medicine, Mikkeli Central Hospital, Mikkeli, Finland.
Susanna
S
Vanhanen
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
Sanna
S
Sinikallio
Kyyhkylä Rehabilitation Center, Mikkeli, Finland.
Timo
T
Aalto
Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
Soili M
SM
Lehto
Department of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio, Finland.
Olavi
O
Airaksinen
Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland.
Heimo
H
Viinamäki
D000368:Aged; D016022:Case-Control Studies; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D019299:Decompression, Surgical / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D011446:Prospective Studies; D012044:Regression Analysis; D013130:Spinal Stenosis / Q000523:psychology* / Q000534:rehabilitation / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Depression; Depressive symptoms; Disability; Lumbar spinal stenosis; Mental health; Surgery outcome