Prediction of postoperative disability in patients with degenerative diseases of the lumbar spine using preoperative psychological factors

Abstract

Background Lumbar degenerative disease has become more common, and surgery is performed in severe cases. However, some patients have residual disabilities. Although psychological factors are the most studied predictors of disability after lumbar spine surgery, it is unclear which factors strongly influence them. Thus, this study aimed to examine multidimensional factors that predict disability in patients postoperatively. Methods This was a retrospective longitudinal study. We collected data on pain intensity, disability, and psychosocial factors a day before surgery. In addition, pain intensity and disability were assessed for the same participants more than 1 year after surgery. Hierarchical multiple regression analysis was used to analyze the preoperative factors associated with the degree of disability in participants at postoperative lumbar surgery. The dependent variable was the Roland Morris disability questionnaire score postoperatively. The independent variables were the preoperative Roland Morris disability questionnaire scores in step 1; the participant's characteristics (age and sex) and numerical rating scale in step 2; Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Hospital Anxiety and Depression Scales as step 3; and the interaction of age with the other variables was added in step 4. Results There were 176 participants in this study. The preoperative Roland Morris disability questionnaire scores (B = 0.140; p < 0.05), age (B = 0.059; p < 0.05), Tampa Scale for Kinesiophobia (B=-0.107; p < 0.05) and preoperative Roland Morris disability questionnaire scores with age interaction (B = 0.014; p < 0.01) were significantly related to disability. The explanatory power was 26.7%. Conclusions This study showed that the preoperative fear of movement was the strongest predictor of postoperative disability after surgery for degenerative diseases of the lumbar spine.