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Mental state as a predictor of outcome in spinal stenosis surgery: Four quadrants model integrating patient satisfaction and functional outcome.
Mental state as a predictor of outcome in spinal stenosis surgery: Four quadrants model integrating patient satisfaction and functional outcome.
- Source :
-
Brain & spine [Brain Spine] 2024 Sep 07; Vol. 4, pp. 103902. Date of Electronic Publication: 2024 Sep 07 (Print Publication: 2024). - Publication Year :
- 2024
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Abstract
- Introduction: Mental status, characterised by anxiety and depression, significantly influences physical well-being, particularly in patients with spinal stenosis symptoms.<br />Research Question: The prevalence of depression and anxiety in our cohort. The correlation between psychological distress and physical outcome after surgery, including postoperative recovery and satisfaction.<br />Materials and Methods: Questionnaires evaluating anxiety and depression (HADS), functionality (ODI), quality of life (EQ-5D), and perceived recovery (Likert-scale) were sent to a randomly selected cohort of 450 lumbar spinal stenosis patients, with or without spondylolisthesis, who underwent surgery between 2007 and 2013. Results are presented, dichotomised by HADS score (score ≥8 indicating psychologically impaired) and in a Four Quadrants Model integrating functional outcomes and perceived recovery separately for psychologically impaired and non-impaired cases.<br />Results: Among the 147 included patients, 32 (22%) exhibited anxiety and/or depression (impaired cases). Satisfactory outcome (perceived recovery) was reported in 29.0% of the impaired cases and 78.3% of the non-impaired cases (p < 0.001). The mean postoperative functionality score of the impaired cases was 42.46 ± 16.24, in contrast to 18.48 ± 18.25 for the non-impaired cases (p < 0.001). In the impaired group, only 12.5% achieved both a good functional outcome (ODI ≤24) and satisfactory perceived recovery, compared with 58.4% in the non-impaired group.<br />Discussion and Conclusion: Patients reporting anxiety and/or depression demonstrate an inferior long-term outcome after spinal stenosis surgery compared to non-impaired patients. This clinically relevant difference underscores the importance of addressing depression and anxiety in preoperative counselling to optimize patient satisfaction and functional outcomes.<br />Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests.Dr. Vleggeert-Lankamp reports a relationship with 10.13039/100002718Cervical Spine Research Society that includes: board membership and funding grants. Dr. Vleggeert-Lankamp reports a relationship with Netherlands Neurosurgical Society (NVvN) that includes: board membership. Dr. Vleggeert-Lankamp reports a relationship with EUROSPINE The Spine Society of Europe that includes: board membership. Dr. Vleggeert-Lankamp reports a relationshiigsp with Advisory Board Rijndam Rehabilitation that includes: consulting or advisory. Dr. Vleggeert-Lankamp reports a relationship with Covidien that includes: funding grants. Dr. Vleggeert-Lankamp reports a relationship with YM Fund that includes: funding grants. Dr. Vleggeert-Lankamp reports a relationship with Achmea Health Insurance that includes: funding grants. Dr. Vleggeert-Lankamp reports a relationship with Nuvasive that includes: speaking and lecture fees. Dr. Vleggeert-Lankamp reports a relationship with Stryker Spine that includes: speaking and lecture fees. Dr. van Furth reports a relationship with Sella Therapies that includes: Co-Founder/CEO.<br /> (© 2024 The Authors. Published by Elsevier B.V. on behalf of EUROSPINE, the Spine Society of Europe, EANS, the European Association of Neurosurgical Societies.)
Details
- Language :
- English
- ISSN :
- 2772-5294
- Volume :
- 4
- Database :
- MEDLINE
- Journal :
- Brain & spine
- Publication Type :
- Academic Journal
- Accession number :
- 39309548
- Full Text :
- https://doi.org/10.1016/j.bas.2024.103902