Clinical and neuropsychiatric correlates of lumbar spinal surgery in older adults: results of a pilot study.
OBJECTIVE
To improve selection of older lumbar surgical candidates, we surveyed correlates of functioning and satisfaction with surgery.


METHODS
Prospective sample at lumbar spine surgery clinic. Patients (n = 48) were evaluated before surgery and after 3 months. Dependent variables were functioning and surgical satisfaction.


RESULTS
Baseline variables associated with disability at 3 months included cognitive status and widespread pain. There was clinically significant improvement with moderate effects sizes for anxiety and depression at follow-up. Patients with at least a 30% improvement in disability had better physical health-related quality of life and were less likely to report widespread pain before surgery.


CONCLUSIONS
Although preliminary, two novel potential predictors of lumbar surgery outcome include diminished cognitive functioning and widespread pain. Further study of these variables on post-surgical functioning and satisfaction may improve patient selection.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.|Geriatric Research Education & Clinical Center (GRECC) VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
Jordan F
JF
Karp
Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Jonathan
J
McGovern
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Megan M
MM
Marron
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Peter
P
Gerszten
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.|Geriatric Research Education & Clinical Center (GRECC) VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.|Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Debra K
DK
Weiner
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
David
D
Okonkwo
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Adam S
AS
Kanter
D000368:Aged; D001007:Anxiety / Q000150:complications; D060825:Cognitive Dysfunction / Q000150:complications; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
aging; complications; lumbar spine; predictors; psychiatric; spinal stenosis