The effects of psychological distress after surgery in patients undergoing lumbar spinal fusion

Abstract

Abstract Purpose The aim of this study was to evaluate the psychological distress pre-operatively, at 3, 6, and 12 months in patients undergoing lumbar spine fusion surgery.Methods A total of 440 patients received instrumented lumbar spine fusion were enrolled. The psychological distress was evaluated using the Modified Somatic Perception Questionnaire (MSPQ) and the Modified Zung Depressive Index (ZDI). The results of lumbar fusion surgery were evaluated using the Oswestry Disability Index (ODI), the Japanese Orthopedic Association (JOA-29), and the visual analog scale (VAS).Results Psychological distress was reported among 23% of patients and 7, 5.5, and 4.0% of the patients pre-operatively, at 3, 6, and 12 months after lumbar surgery, respectively. The mean MSPQ score decreased from 8.78 (before operation) to 4.30, 3.52, and 3.43 at postoperative 3, 6 and 12 months inpsychological distress patients (p < 0.001). The mean ZDI score decreased from 17.78 to 12.48, 10.35, and 9.61 (p < 0.001). The mean ODI score decreased from 22.91 to 11.78, 10.13, and 9.96 (P < 0.001). The mean JOA score increased from13.65 to 22.30, 23.43, and 23.61 (P < 0.001). The mean low back pain (LBP VAS) score decreased from 4.48 to 1.96, 1.52, and 1.51 (P < 0.001), moreover, the mean leg pain (LP VAS) score decreased from 5.30 to 1.30, 1.04, and 1.03 (P < 0.001).Conclusions Psychological distress patients with may experience surgical intervention benefits of equal with ordinary patients. Moreover, reduced pain and disability after the surgical intervention may also alleviate psychological distress. Hence, we highly recommend psychological distress patients undergo surgical intervention like normal patients, but the appropriate screening measures and interventions are necessary.