Article
Predictors of clinical outcome in cervical arthrodesis: Evaluation of physical, mental and social factors
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Published: | June 9, 2017 |
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Outline
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Objective: The influence of psychological and social factors has only recently been acknowledged to impact clinical outcome following spine surgery. Some studies demonstrated that preoperative affective disorders predicts poor outcome after spinal surgery. We aimed to identify potential risk factor for unfavourable outcome following cervical spine surgery for degenerative disc disease.
Methods: In a prospective observational study the authors determined quantitative measurements of pain (visual analog scale [VAS]), health related quality of life ( HRQL: SF-36 and EuroQOL-5D), disease-specific disability (ODI), metal status (anxiety [STAI-T, STAI-S and ASI-3] and Depression [ASD-K]) and social status (Berliner Social Support Scale [BSSS] and education level). Uni- and multivariate analyses were performed to assess associations between the various preoperative factors and the health related quality of life (HRQL) at 12 months follow up.
Results: 51 patients met all inclusion criteria. 34 patients were male (66.7%); mean age was 58.6 years. Most patients were married or in a steady relationship (78.4%). Preoperatively high values in education (r=0.293; p=0.07), SF-36 PCS (r=0.405; p=0.022) and low scores of depression (ASD-K: r=-0.363; p=0.011) and anxiety (ASI-3: r=-0.354; p=0.013) and ODI (r=-0.343; p=0.038) correlated with better HRQL at 1 year postoperatively.
Conclusion: Clinical outcome one year after surgery is influenced by pre-operative physical, mental and social status. A screening instrument allowing the identification of such patients is feasible.