title: Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease.
  
  
  METHODS
  The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140).
  
  
  RESULTS
  Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery (p=0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery (p=0.368).
  
  
  CONCLUSIONS
  This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.
authors.affiliation: Neurological and Neurosurgical Nursing Department.
authors.forename: Renata
authors.initials: R
authors.lastname: Jabłońska
authors.affiliation: Neurological and Neurosurgical Nursing Department.
authors.forename: Robert
authors.initials: R
authors.lastname: Ślusarz
authors.affiliation: Neurological and Neurosurgical Nursing Department.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Królikowska
authors.affiliation: Neurological and Neurosurgical Nursing Department.
authors.forename: Beata
authors.initials: B
authors.lastname: Haor
authors.affiliation: Neurological and Neurosurgical Nursing Department.
authors.forename: Anna
authors.initials: A
authors.lastname: Antczak
authors.affiliation: Department of Surgery Nursing, Faculty of Health Science, The Ludwik Rydygier Collegium Medicum in Bydgoszcz, The Nicolaus Copernicus University,Toruń, Bydgoszcz, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Szewczyk
keywords: degenerative disc disease; depression; intervertebral disc; surgery