gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Post traumatic stress disorder symptoms following elective spine surgery. Is surgery really the reason?

Meeting Abstract

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  • Ehab Shiban - Neurochirurgische Klinik, Technische Universität München
  • Youssef Shiban - Klinische Psychologie und Psychotherapie, Universitätsklinikum Regensburg
  • Corinna Kapp - Neurochirurgische Klinik, Technische Universität München
  • Leila Sahinovic - Neurochirurgische Klinik, Technische Universität München
  • Michael Eisenburger - Neurochirurgische Klinik, Technische Universität München
  • Verena Kammermeier - Neurochirurgische Klinik, Technische Universität München
  • Andreas Mühlberger - Klinische Psychologie und Psychotherapie, Universitätsklinikum Regensburg
  • Jens Lehmberg - Neurochirurgische Klinik, Technische Universität München
  • Bernhard Meyer - Neurochirurgische Klinik, Technische Universität München

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocP 093

doi: 10.3205/15dgnc491, urn:nbn:de:0183-15dgnc4919

Published: June 2, 2015

© 2015 Shiban et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Recently, posttraumatic stress disorder symptoms (PTSD) were found in 20% of cases following elective spine surgery. PTSD was therefore attributed to surgery. Furthermore, PTSD symptoms were associated with reduced clinical benefit. However, PTSD is seen in up to 15% of the normal population. Aim of this study is to evaluate the incidence of PTSD before and after elective spine surgery and the influence of PTSD on clinical outcome.

Method: A prospective study of patients undergoing elective spine surgery was performed. The patients were evaluated for PTSD using the PTSS score before surgery and 3 months postoperatively. In addition SF36 physical composite score (PCS), Oswestry Disability Index (ODI) and pain visual analog scale (VAS) were completed preoperatively and at 3 months postoperatively. Incidence and influence of PTSD symptoms on clinical outcome were examined.

Results: 104 patients met all inclusion criteria. 56 patients were male (53.8%); mean age was 59.7 years. PTSD symptoms were reported in 38 patients (36.5%) before surgery. However, only 16 patients (15.3%) still had abnormal PTSS scores at 3 months follow-up. Only 4 patients (3%) developed PTSD symptoms following surgery. PTSD was associated with worse clinical outcome before surgery only in the ODI score (ODI: 42.6 vs. 30.9, P=0.018). There were no statistically significant differences in mean SF36 PCS score (P=0.934) or pain VAS (P=0.440) between both groups. At three months follow-up patients with PTSD showed worse clinical outcome in the ODI score and VAS pain (ODI: 42.6 vs 19.7, P<0.001; VAS: 5.3 vs 3.2, P=0.001) but not in the SF36 PCS score (P=0.107).

Conclusions: PTSD symptoms are associated with worse outcome following elective spine surgery. However, the vast majority of patients exhibit PTSD symptoms before surgery and only a small minority develop PTSD symptoms after surgery.

Note: Ehab Shiban and Youssef Shiban contributed equally.