Depressive symptoms are associated with poor outcome for lumbar spine surgery

Järvimäki, Voitto; Kautiainen, Hannu; Haanpää, Maija; Koponen, Hannu; Spalding, Michael; Alahuhta, Seppo; Vakkala, Merja

doi:10.1016/j.sjpain.2016.01.008

Cited by 11 publications

(6 citation statements)

References 34 publications

(36 reference statements)

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“…Our study was not designed for prognostic factor research, which focuses on identifying independent prognostic (risk) factors [30,34]. Still, our results can lend support to previously studies identifying a long duration of low back pain and leg pain, anxiety and/or depression, previous back surgery, smoking, lower education, BMI, and unresolved disability pension or insurance issues as predictors for inferior outcomes [12,15,17,18,29].…”

Section: Discussionsupporting

confidence: 76%

“…We included prognostic factors, previously reported in the literature [10,12,15,17,18,29]. Sociodemographic and anthropometric factors included were; gender, age > 60, obesity (body mass index, BMI ≥ 30), marital status (living alone yes/no), employment status (employed/unemployed), and low educational level (yes/no), i.e., less than 4 years of college/university education.…”

Section: Possible Prognostic Factorsmentioning

confidence: 99%

“…Patients were also asked if they had a pending or unresolved claim or litigation issue (yes/no) against (1) the Norwegian public welfare agency fund concerning permanent disability pension or (2) a compensation claim against private insurance companies or the public Norwegian System of Compensation to Patients. As shown in the tables, we also assessed other clinical parameters, including the baseline PROM scores, smoking, duration of symptoms, previous lumbar spine surgery, and use of analgesics [12,15,17,18,29].…”

Section: Possible Prognostic Factorsmentioning

confidence: 99%

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A prognostic model for failure and worsening after lumbar microdiscectomy: a multicenter study from the Norwegian Registry for Spine Surgery

et al. 2021

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Objective To develop a prognostic model for failure and worsening 1 year after surgery for lumbar disc herniation. Methods This multicenter cohort study included 11,081 patients operated with lumbar microdiscectomy, registered at the Norwegian Registry for Spine Surgery. Follow-up was 1 year. Uni- and multivariate logistic regression analyses were used to assess potential prognostic factors for previously defined cut-offs for failure and worsening on the Oswestry Disability Index scores 12 months after surgery. Since the cut-offs for failure and worsening are different for patients with low, moderate, and high baseline ODI scores, the multivariate analyses were run separately for these subgroups. Data were split into a training (70%) and a validation set (30%). The model was developed in the training set and tested in the validation set. A prediction (%) of an outcome was calculated for each patient in a risk matrix. Results The prognostic model produced six risk matrices based on three baseline ODI ranges (low, medium, and high) and two outcomes (failure and worsening), each containing 7 to 11 prognostic factors. Model discrimination and calibration were acceptable. The estimated preoperative probabilities ranged from 3 to 94% for failure and from 1 to 72% for worsening in our validation cohort. Conclusion We developed a prognostic model for failure and worsening 12 months after surgery for lumbar disc herniation. The model showed acceptable calibration and discrimination, and could be useful in assisting physicians and patients in clinical decision-making process prior to surgery.

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Section: Discussionsupporting

confidence: 76%

Section: Possible Prognostic Factorsmentioning

confidence: 99%

Section: Possible Prognostic Factorsmentioning

confidence: 99%

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A prognostic model for failure and worsening after lumbar microdiscectomy: a multicenter study from the Norwegian Registry for Spine Surgery

et al. 2021

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“…El dolor lumbar crónico y la depresión son dos de los problemas más comunes que enfrentan los profesiona-les de la salud, sobre todo por una prevalencia de un estado depresivo que puede variar entre el 16,4 % y el 73,3 % y por su asociación con una disminución en la efectividad de los tratamientos para el dolor (28). Con respecto al tratamiento de la patología de raquis, un estudio transversal realizado en 537 pacientes observó que los pacientes con sintomatología depresiva presentaron peores resultados evolutivos de forma significativa (p < 0,001) tras la intervención: escala de discapacidad por dolor lumbar de Oswestry (36-42 vs. 16), presencia de dolor (81-88 % vs. 40 %) y uso continuo de medicación analgésica (93 % vs. 71 %) (29). En nuestro estudio observamos que los pacientes con sintomatología depresiva no presentaron un riesgo incrementado de escasa mejoría clínica (p = 0,115), pero sí se reflejaba indirectamente en una disminución no significativa de la EVA (p = 0,317) y en una no mejora en el EuroQol (p = 0,387) tras la realización de un procedimiento intervencionista para el tratamiento del dolor.…”

Section: Discussionunclassified

El papel de la sintomatología depresiva, catastrofismo y expectativa en la eficacia de las técnicas intervencionistas para el tratamiento del dolor lumbar crónico

Huaranga

Vedia

Ezaine

et al. 2019

Rev. Soc. Esp. Dolor.

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“…Depressive symptoms have been shown to be associated with poor outcomes after lumbar spine surgery. 14,15 It has also been reported that patients who recover from depression have similar postoperative improvements compared with patients without depression. 15 Our findings further suggest that and emphasis on identifying and addressing mental health needs prior to surgery may aid in improving satisfaction with care.…”

Section: E523mentioning

confidence: 93%

Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

Rae

Rocha

Hayes

et al. 2021

Spine

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Study Design. Case-control study. Objective. To analyze patient complaints, potential risk, and malpractice events involving orthopedic spine surgeons over a 10-year period. Summary of Background Data. Unsolicited patient complaints may be associated with risk management and malpractice events. Methods. We analyzed patient complaint, potential risk event, and malpractice event data for six orthopedic spine surgeons over a 10-year period. Patient complaints were analyzed and classified according to the Patient Complaint Analysis System. Baseline demographics were recorded for patients with complaints as well as the surgeons. A control group consisting of all patients seen by the six surgeons during the study period was created to identify patient and physician risk factors for formal patient complaints. Event rates (for complaints, risk, and malpractice events) were calculated by dividing the number of events by the total number of unique patients seen. Results. There were 214 complaint designations among 202 patients with formal complaints, resulting in a complaint rate of 0.79%. Patients were most likely to complain about access and availability (35%) followed by care and treatment (32%). Of the 68 complaints regarding care and treatment, 34 were related to dissatisfaction with surgical outcome. Complications were identified in 26/34 cases. The malpractice event rate ranged from 0.06% to 0.65%. Patients who had surgery (P< 0.0001) or a mental, behavioral, or neurodevelopmental disorder (P = 0.0004) were more likely to file complaints compared with the control group. Conclusion. While infrequent, patient complaints against orthopedic spine surgeons are most related to access and availability. The rate of malpractice events varies widely between surgeons.

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Depressive symptoms are associated with poor outcome for lumbar spine surgery

Cited by 11 publications

References 34 publications

A prognostic model for failure and worsening after lumbar microdiscectomy: a multicenter study from the Norwegian Registry for Spine Surgery

A prognostic model for failure and worsening after lumbar microdiscectomy: a multicenter study from the Norwegian Registry for Spine Surgery

El papel de la sintomatología depresiva, catastrofismo y expectativa en la eficacia de las técnicas intervencionistas para el tratamiento del dolor lumbar crónico

Formal Patient Complaints and Malpractice Events Involving Orthopedic Spine Surgeons

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